Background Restriction of sodium intake is routinely recommended for patients with chronic kidney disease (CKD). Whether or not sodium intake is associated with the progression of CKD and mortality remains uncertain. We evaluated the association between urinary sodium excretion (as a surrogate for sodium intake) with the occurrence of renal failure and mortality in patients with non-dialytic CKD. Methods We conducted a retrospective study of patients followed at a CKD clinic care hospital from October 2006 to March 2017. Adult patients with non-dialytic CKD were included. Using a time-to-event analysis, we examined the association of urinary sodium excretion as a categorical variable (categorized as quintiles: 1st quintile: 0.54–2.51 g; 2nd quintile: 2.52–3.11 g, 3rd quintile: 3.12–3.97 g, 4th quintile: 3.98–5.24 g and 5th quintile: 5.26–13.80 g) and the outcomes of interest. The primary outcome was defined as progression to end-stage renal disease requiring any type of renal replacement therapy. The secondary outcome was mortality. Results Two hundred five patients were included in the study (mean follow up of 2.6 years) with a mean eGFR of 26 (19–41) ml/min/1.73m2. 37 patients (18%) required renal replacement therapy and 52 (25,3%) died. There was association between urinary sodium excretion and need for renal replacement therapy (adjusted HR 0.245; 95%CI 0.660–0.912). There was no association between urinary sodium excretion and mortality in adjusted models. Conclusion Moderate sodium intake was associated with a lower risk of renal failure.
Background: If sodium intake directly affect the progression to renal failure or death in non-dialysis chronic kidney disease (CKD) patients remains uncertain. We evaluated the association between urinary sodium excretion (as a surrogate for sodium intake) with the occurrence of renal failure and death in non-dialytic CKD patients. Methods: A cohort study of non-dialytic CKD patients, including patients that who have their first visit clinical appointment between October/2006 and November/2010 and followed until March/2017. The inclusion criteria were: at least two 24-hour urinary sodium samples evaluated and aged superior to over 18 years, and the exclusion criteria were: patients who underwent undergoing previous dialysis therapy previously, with in the malignant phase of hypertension, hepatic insufficiency, alcoholics, malignant neoplasms, and implausible biochemical examination values. To measure sodium intake, two 24-hour urinary sodium samples were collected at the first visit appointment and or at maximum six months later. The outcomes were renal failure (onset of renal replacement therapy (RRT)) and death. Multiple Cox regression model was adjusted for age, creatinine clearance, smoking, and proteinuria/creatininuria ratio. Results: Were screened 292 patients and included 205 patients; during the follow-up period (until 125 months) there were 52 deaths and 37 patients developed renal failure. Considering the first quintile (urinary sodium below 2.51 g/day) as a reference, the second quintile (2.52 and 3.11 g/day) presented an adjusted Hazard Ratio of 0.245 (95% confidence interval: 0.660-0.912; p=0.036). Other quintiles did not present statistically significant association with renal outcome. There were no associations between the quintiles of urinary sodium excretion and death. Conclusion: Moderate sodium intake was associated with a lower risk of renal failure.
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