TY - JOUR
T1 - Results of the CARDIA study suggest that higher dietary potassium may be kidney protective
AU - Elfassy, Tali
AU - Zhang, Lanyu
AU - Raij, Leopoldo
AU - Bibbins-Domingo, Kirstin
AU - Lewis, Cora E.
AU - Allen, Norrina Bai
AU - Liu, Kiang J.
AU - Peralta, Carmen A.
AU - Odden, Michelle C.
AU - Zeki Al Hazzouri, Adina
N1 - Funding Information:
Funding for this study was provided in part by a grant from the American Heart Association ( 17POST32490000). TE is currently supported by a grant from the National Institutes of Health / National Institute on Minority Health and Health Disparities ( K01MD014158 ). Funders did not have a role in the study design, analysis, interpretation, writing, or the decision to submit the report for publication.
Funding Information:
The Coronary Artery Risk Development in Young Adults (CARDIA) Study is supported by contracts HHSN268201300025C , HHSN268201300026C , HHSN268201300027C , HHSN268201300028C , HHSN268201300029C , and HHSN268200900041C from the National Heart, Lung, and Blood Institute and the Intramural Research Program of the National Institute on Aging .
Publisher Copyright:
© 2020 International Society of Nephrology
PY - 2020/7
Y1 - 2020/7
N2 - The association between dietary sodium and potassium intake with the development of kidney disease remains unclear, particularly among younger individuals. Here, we determined whether dietary sodium and potassium intake are associated with incident chronic kidney disease (CKD) using data from 1,030 adults (age 23-35 in 1990-1991) from the Coronary Artery Risk Development In Young Adults study, based on repeated measurements of estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (ACR) from 1995 through 2015. Urinary sodium and potassium excretion (mg/day), calculated from three 24-hour urine collections in 1990-1991, were averaged to measure sodium and potassium intake. Serum creatinine was used to calculate eGFR using the CKD EPI equation; spot urine albumin and creatinine were used to calculate ACR, each at five visits from 1995-1996 through 2015-2016. CKD was defined as decreased eGFR (under 60 ml/min/1.73m2) or the development of albuminuria (ACR over 30 mg/g). We used log binomial regression models adjusted for socio-demographic, behavioral, and clinical factors to determine whether sodium and potassium intake were associated with incident CKD (decreased eGFR or developed albuminuria) among those free of CKD in 1995. Dietary sodium intake was not significantly associated with incident CKD. However, every 1,000 mg/day increment of potassium intake in 1990 was significantly associated with a 29% lower risk of incident albuminuria (relative risk 0.71, 95% confidence interval 0.53, 0.95), but not eGFR. Thus, higher dietary potassium intake may protect against the development of kidney damage, particularly albuminuria.
AB - The association between dietary sodium and potassium intake with the development of kidney disease remains unclear, particularly among younger individuals. Here, we determined whether dietary sodium and potassium intake are associated with incident chronic kidney disease (CKD) using data from 1,030 adults (age 23-35 in 1990-1991) from the Coronary Artery Risk Development In Young Adults study, based on repeated measurements of estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (ACR) from 1995 through 2015. Urinary sodium and potassium excretion (mg/day), calculated from three 24-hour urine collections in 1990-1991, were averaged to measure sodium and potassium intake. Serum creatinine was used to calculate eGFR using the CKD EPI equation; spot urine albumin and creatinine were used to calculate ACR, each at five visits from 1995-1996 through 2015-2016. CKD was defined as decreased eGFR (under 60 ml/min/1.73m2) or the development of albuminuria (ACR over 30 mg/g). We used log binomial regression models adjusted for socio-demographic, behavioral, and clinical factors to determine whether sodium and potassium intake were associated with incident CKD (decreased eGFR or developed albuminuria) among those free of CKD in 1995. Dietary sodium intake was not significantly associated with incident CKD. However, every 1,000 mg/day increment of potassium intake in 1990 was significantly associated with a 29% lower risk of incident albuminuria (relative risk 0.71, 95% confidence interval 0.53, 0.95), but not eGFR. Thus, higher dietary potassium intake may protect against the development of kidney damage, particularly albuminuria.
KW - albuminuria
KW - chronic kidney disease (CKD)
KW - eGFR
KW - urine potassium
KW - urine sodium
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U2 - 10.1016/j.kint.2020.02.037
DO - 10.1016/j.kint.2020.02.037
M3 - Article
C2 - 32471640
AN - SCOPUS:85085351649
SN - 0085-2538
VL - 98
SP - 187
EP - 194
JO - Kidney International
JF - Kidney International
IS - 1
ER -