Sodium Linked to Increased CV Risk in Patients with CKD

Higher urinary sodium excretion is linked to increased risk of cardiovascular disease (CVD) among patients with chronic kidney disease (CKD), according to a recent study.

Patients with CKD have a higher risk of CVD, and although previous research has found that dietary sodium intake is linked to CVD risk, the connection has not been examined in patients with CKD specifically.
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The researchers performed a prospective cohort study in which they followed 3757 patients with CKD from 7 locations in the United States who participated in the Chronic Renal Insufficiency Cohort Study and followed up from May 2003 to March 2013.

They collected 24-hour urine specimens from patients at baseline and then annually for 2 years. They then compared the cumulative mean of urinary sodium excretion from three 24-hour urinary measurements to the sex-specific mean 24-hour urinary creatinine excretion.

After a median 6.8-year follow-up, the researchers found that 21% of patients (mean age of 58 years) experienced a CVD event, including heart failure, a heart attack, or a stroke.

Patients in the highest quartile of urinary sodium excretion (4548 mg/24 h or higher) were 36% more likely to experience a CVD event than those in the lowest quartile (less than 2894 mg/24 h).

In addition, those in the highest quartile were 23% more likely to have heart failure, 11% more likely to have a heart attack, and 6% more likely to have a stroke than those in the lowest quartile (13%, 8%, and 3%, respectively).

“Among patients with CKD, higher urinary sodium excretion was associated with increased risk of CVD,” the researchers concluded.

—Amanda Balbi

Reference:

Mills KT, Chen J, Yang W, et al. Sodium excretion and the risk of cardiovascular disease in patients with chronic kidney disease. JAMA. 2016;315(20):2200-2210.