Estimated 24-h urinary sodium excretion and risk of end-stage kidney disease

Ying Shan; Yong Bai; Jingwen Zhang; Yueqi Lu; Sike Yu; Congying Song; Juehan Liu; Min Jian; Junjie Xu; Changhai Ding; Zuying Xiong; Xiaoyan Huang

doi:10.1016/j.isci.2023.106728

Estimated 24-h urinary sodium excretion and risk of end-stage kidney disease

iScience. 2023 Apr 23;26(5):106728. doi: 10.1016/j.isci.2023.106728. eCollection 2023 May 19.

Authors

Ying Shan¹, Yong Bai², Jingwen Zhang³, Yueqi Lu², Sike Yu², Congying Song¹, Juehan Liu², Min Jian², Junjie Xu¹, Changhai Ding⁴, Zuying Xiong³, Xiaoyan Huang^{1

3}

Affiliations

¹ Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen 518036, China.
² BGI-Shenzhen, Shenzhen 518083, China.
³ Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen 518036, China.
⁴ Clinical Research Centre of Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.

Abstract

The association between sodium intake and long-term kidney disease endpoints is debated and yet to be proven. We aimed to investigate the associations of estimated 24-h urinary sodium excretion, reflecting daily sodium intake, with the incidence of end-stage kidney disease (ESKD). In this prospective cohort study including 444,375 UK Biobank participant, 865 (0.2%) ESKD events occurred after median follow-up of 12.7 years. For every 1 g increment in estimated 24-h urinary sodium excretion, multivariable-adjusted hazard ratio for incident ESKD was 1.09 (95% confidence interval 0.94-1.26). Nonlinear associations were not detected with restricted cubic splines. The null findings were confirmed by a series of sensitivity analyses, which attenuated potential bias from measurement errors of the exposure, regression dilution, reverse causality, and competing risks. In conclusion, there is insufficient evidence that estimated 24-h urinary sodium excretion is associated with the incidence of ESKD.

Keywords: Health sciences; Human Physiology; Nephrology.