High and low sodium intakes are associated with incident chronic kidney disease in patients with normal renal function and hypertension

Chang Yun Yoon, Juhwan Noh, Jinae Lee, Youn Kyung Kee, Changhwan Seo, Misol Lee, Min Uk Cha, Hyoungnae Kim, Seohyun Park, Hae Ryong Yun, Su Young Jung, Jong Hyun Jhee, Seung Hyeok Han, Tae Hyun Yoo, Shin Wook Kang, Jung Tak Park

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Abstract

The association between salt intake and renal outcome in subjects with preserved kidney function remains unclear. Here we evaluated the effect of sodium intake on the development of chronic kidney disease (CKD) in a prospective cohort of people with normal renal function. Data were obtained from the Korean Genome and Epidemiology Study, a prospective community-based cohort study while sodium intake was estimated by a 24-hour dietary recall Food Frequency Questionnaire. A total of 3,106 individuals with and 4,871 patients without hypertension were analyzed with a primary end point of CKD development [a composite of estimated glomerular filtration rate (eGFR) under 60 mL/min/1.73 m2 and/or development of proteinuria during follow-up]. The median ages were 55 and 47 years, the proportions of males 50.9% and 46.3%, and the median eGFR 92 and 96 mL/min/1.73 m2 in individuals with and without hypertension, respectively. During a median follow-up of 123 months in individuals with hypertension and 140 months in those without hypertension, CKD developed in 27.8% and 16.5%, respectively. After adjusting for confounders, multiple Cox models indicated that the risk of CKD development was significantly higher in people with hypertension who consumed less than 2.08 g/day or over 4.03 g/day sodium than in those who consumed between 2.93–4.03 g/day sodium. However, there was no significant difference in the incident CKD risk among each quartile of people without hypertension. Thus, both high and low sodium intakes were associated with increased risk for CKD, but this relationship was only observed in people with hypertension.

Original languageEnglish
Pages (from-to)921-931
Number of pages11
JournalKidney International
Volume93
Issue number4
DOIs
Publication statusPublished - 2018 Apr

All Science Journal Classification (ASJC) codes

  • Nephrology

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    Yoon, C. Y., Noh, J., Lee, J., Kee, Y. K., Seo, C., Lee, M., Cha, M. U., Kim, H., Park, S., Yun, H. R., Jung, S. Y., Jhee, J. H., Han, S. H., Yoo, T. H., Kang, S. W., & Park, J. T. (2018). High and low sodium intakes are associated with incident chronic kidney disease in patients with normal renal function and hypertension. Kidney International, 93(4), 921-931. https://doi.org/10.1016/j.kint.2017.09.016