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Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents

Author

Listed:
  • Hiroko Hattori

    (Graduate School of Health management, Keio University, Kanagawa 252-0883, Japan
    Department of Health and Nutrition, Tokiwa University of Human Science, Ibaraki 310-8585, Japan)

  • Aya Hirata

    (Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
    Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan)

  • Sachimi Kubo

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Faculty of Human Sciences, Tezukayama Gakuin University, Osaka 590-0113, Japan)

  • Yoko Nishida

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan)

  • Miki Nozawa

    (Japan Health Insurance Association, Saitama 330-8686, Japan)

  • Kuniko Kawamura

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan)

  • Takumi Hirata

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Department of Public Health, Hokkaido University Faculty of Medicine, Hokkaido 060-8638, Japan)

  • Yoshimi Kubota

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Hyogo 663-8501, Japan)

  • Mizuki Sata

    (Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
    Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan)

  • Kazuyo Kuwabara

    (Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
    Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan)

  • Aya Higashiyama

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Department of Hygiene, Wakayama Medical University, Wakayama 641-8509, Japan)

  • Aya Kadota

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Center for Epidemiologic Research in Asia Shiga University of Medical Science, Shiga 520-2192, Japan)

  • Daisuke Sugiyama

    (Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
    Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Faculty of Nursing and Medical Care, Keio University, Kanagawa 252-0883, Japan)

  • Naomi Miyamatsu

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Department of Clinical Nursing, Shiga University of Medical Science, Shiga 520-2192, Japan)

  • Yoshihiro Miyamoto

    (Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
    Open Innovation Center, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan)

  • Tomonori Okamura

    (Graduate School of Health management, Keio University, Kanagawa 252-0883, Japan
    Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
    Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan)

Abstract

The effect of the sodium-to-potassium ratio (Na/K) on renal function within the clinically normal range of renal function are limited. We investigated the effects of an estimated 24 h urinary Na/K (e24hUNa/K) on a 6-year renal function decline among 927 urban Japanese community dwellers with no history of cardiovascular diseases and medication for hypertension, diabetes, or dyslipidemia. We partitioned the subjects into quartiles according to the e24hUNa/K. The estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD/EPI) formula and renal function decline was defined as an absolute value at or above the third quartile of the eGFR decline rate. A multivariable logistic regression model was used for estimation. Compared with the first quartile of the e24hUNa/K, multivariable-adjusted odds ratios (ORs) for eGFR decline in the second, third, and fourth quartiles were 0.96 (95% confidence interval: 0.61–1.51), 1.06 (0.67–1.66), and 1.65 (1.06–2.57), respectively. These results were similar when the simple spot urine Na/K ratio was used in place of the e24hUNa/K. Apparently healthy urban residents with an almost within normal range mean baseline eGFR and high e24hUNa/K ratios had an increased risk for a future decline in renal function. Reducing the Na/K ratio may be important in the prevention of chronic kidney disease in its early stage.

Suggested Citation

  • Hiroko Hattori & Aya Hirata & Sachimi Kubo & Yoko Nishida & Miki Nozawa & Kuniko Kawamura & Takumi Hirata & Yoshimi Kubota & Mizuki Sata & Kazuyo Kuwabara & Aya Higashiyama & Aya Kadota & Daisuke Sugi, 2020. "Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents," IJERPH, MDPI, vol. 17(16), pages 1-12, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:16:p:5811-:d:397533
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    References listed on IDEAS

    as
    1. Tomofumi Nishikawa & Naomi Miyamatsu & Aya Higashiyama & Yoshimi Kubota & Yoko Nishida & Takumi Hirata & Daisuke Sugiyama & Kazuyo Kuwabara & Sachimi Kubo & Yoshihiro Miyamoto & Tomonori Okamura, 2019. "Being Conscious of Water Intake Positively Associated with Sufficient Non-Alcohol Drink Intake Regardless of Seasons and Reasons in Healthy Japanese; the KOBE Study: A Cross Sectional Study," IJERPH, MDPI, vol. 16(21), pages 1-13, October.
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