Dietary Sodium, Potassium, and Sodium to Potassium Ratio in Patients With Systemic Lupus Erythematosus

Abstract

Purpose: The aim of this study was to investigate the association between dietary sodium, potassium, and sodium:potassium ratio and clinical disease activity parameters, damage accrual, and cardiovascular disease risk factors in a population of patients with systemic lupus erythematous (SLE). Research design and study sample: A cross-sectional study including a total of 280 patients was conducted (90.4% females; mean age 46.9 ± 12.85 years). Data collection: The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. A 24-hour diet recall was used to estimate dietary intake of sodium and potassium. Results: Dietary sodium intake was significantly associated with anti-dsDNA ( β = −.005; 95% CI [.002 .008]; p = .001) and complement C4 level ( β = −.002; 95% CI [−.003, .000]; p = .039). Dietary potassium intake was also significantly associated with complement C3 level ( β = −.004; 95% CI [−.007, −.001]; p = .021). Multiple logistic regression models revealed a positive association between dietary sodium intake and the risk of having hsCRP > 3 ( p = .005) and an inverse association between dietary potassium intake and the risk of having hsCRP > 3 ( p = .004). Conclusions: SLE patients with higher dietary sodium and lower dietary potassium intakes had an increased risk of higher hsCRP. Dietary sodium intake was significantly associated with anti-dsDNA and complement C4 level, while dietary potassium intake was associated with complement C3 level, supporting that dietary sodium and potassium intakes might play a key role in markers related to disease activity in SLE patients.

Differential impact of environmental factors on systemic and localized autoimmunity

“…Studies on the effect of sodium in SLE are limited, but recent work has highlighted that low sodium regimen diet resulted in a reduction of Th17 percentages (p=0.001), while Tregs percentages increased, therefore suggesting a link between salt intake and autoimmunity (p=0.02) (246). One study exploring high dietary intake of sodium and low potassium intake in SLE patients found an association with an increased risk of high-sensitivity CRP (p=0.004), a marker of disease activity and cardiovascular risk, supporting the potential for sodium to adversely affect inflammation (247). High sodium was also associated with anti-dsDNA (p=0.001) and complement C4 (p=0.039), while low potassium was associated with C3 level (247).…”

“…One study exploring high dietary intake of sodium and low potassium intake in SLE patients found an association with an increased risk of high-sensitivity CRP (p=0.004), a marker of disease activity and cardiovascular risk, supporting the potential for sodium to adversely affect inflammation (247). High sodium was also associated with anti-dsDNA (p=0.001) and complement C4 (p=0.039), while low potassium was associated with C3 level (247). These findings indicated that these disease activity biomarkers in lupus may be affected by consumption of sodium and potassium.…”

Systemic lupus erythematosus: latest insight into etiopathogenesis

“…A high salt diet can also accelerate the development of lupus through the regulation of dendritic cell activity via MAPK and STAT1 signaling pathways [ 123 ]. Higher dietary sodium and lower dietary potassium intake were significantly correlated with C-reactive protein (CRP), which may lead to an increase in disease severity [ 124 ]. A diet rich in eicosapentaenoic acid (EPA) was found to ameliorate the lupus nephritis manifestations including immune complex accumulation and autoantibody generation in the kidney [ 125 ].…”