Effectiveness of a Spot Urine Method in Evaluating Daily Salt Intake in Hypertensive Patients Taking Oral Antihypertensive Drugs

Kawamura, Minoru; Kusano, Yuki; Takahashi, Toru; Owada, Masahiko; Sugawara, Takashi

doi:10.1291/hypres.29.397

Cited by 49 publications

(44 citation statements)

References 27 publications

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“…*Cut points for the quartiles of daily salt intake were 8, 10 and 12 g. Low daily salt intake and albuminuria K Sakabe et al values obtained from the spot urine method correlated highly with those obtained from 24-h urinary sodium excretion, 19 and the usefulness of the spot urine method has been confirmed in population studies 20 and in hypertensive patients. 21 We speculate that excessive dietary salt restriction leads to increased angiotensin II and aldosterone levels, chiefly via an increase in plasma renin activity. Protein consumption is also known to be a critical factor in albuminuria.…”

Section: Discussionmentioning

confidence: 90%

Low daily salt intake is correlated with albuminuria in patients with type 2 diabetes

et al. 2012

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Both high and low salt intakes have been reported to be associated with an increased risk of cardiovascular events. The aim of this study was to investigate the relationship between daily salt intake and albuminuria, a marker of diabetic nephropathy and cardiovascular disease, in patients with type 2 diabetes. We classified 270 patients with type 2 diabetes, who were not receiving antihypertensive medication into four groups according to their daily salt intake (o8, 8-10, 10-12 and 412 g per day). We investigated the relationship between daily salt intake and the logarithm of urinary albumin excretion (UAE). A multivariate linear regression analysis was used to evaluate whether daily salt intake independently correlated with the logarithm of UAE. In addition, we assessed the contribution of the variables, including age, sex, duration of diabetes, body mass index, systolic blood pressure, hemoglobin A 1C , low-density lipoprotein cholesterol, triglycerides, serum creatinine, alcohol intake, smoking status and square of (daily salt intake À10) on albuminuria, defined as a UAE430 mg g À1 of creatinine, using a multiple logistic regression analysis. The logarithm of the UAE was lowest in the third quartile of daily salt intake. The multivariate linear regression analysis demonstrated that the logarithm of the UAE was significantly correlated with the quadratic term of daily salt intake centered at 10 g per day (b ¼ 0.170, P ¼ 0.008). The multivariate logistic regression analysis demonstrated that the odds ratio (95% confidence interval) of albuminuria was 3.996 (1.295-12.327; P ¼ 0.016) in patients whose daily salt intake was less than 8 g per day compared with patients whose daily salt intake was 10-12 g per day. In conclusion, low daily salt intake was correlated with albuminuria in patients with type 2 diabetes, who were not receiving antihypertensive medication.

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Section: Discussionmentioning

confidence: 90%

Low daily salt intake is correlated with albuminuria in patients with type 2 diabetes

et al. 2012

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“…However, this finding should be carefully analyzed, because the method for urine collection was different in previous studies. It is worth to mention that the subgroups that mostly benefitted from the reduction in salt consumption, such as hypertensive people, still consume much more than the recommended amount 29,31 . Similarly to what was observed in other studies 12,13,[23][24][25] , we observed moderate correlation between the salt intake estimated by casual urine and the consumption measured in 24 hours.…”

Section: Discussionmentioning

confidence: 99%

Estudo de validação das equações de Tanaka e de Kawasaki para estimar a excreção diária de sódio através da coleta da urina casual

Mill

Rodrigues

Baldo

et al. 2015

Rev. bras. epidemiol.

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ABSTRACT:Objective: To validate Tanaka and Kawasaki's formulas to calculate the salt intake by the sodium/creatinine ratio in spot of urine. Methods: Two hundred and seventy two adults (20 -69 years old; 52.6% women) with 24 h urine collection and two urinary spots collected on the same day (while fastingspot 1 -or not fasting -spot 2). Anthropometry, blood pressure and fasting blood were measured on the same day. The analysis of agreement between salt consumption measured in the 24 h urine test and urinary spots were determined by the Pearson's correlation (r) and the Bland & Altman method. Results: The mean salt consumption measured by the 24 h sodium excretion was 10.4 ± 5.3 g/day. The correlation between the measured 24 h sodium excretion and the estimation based on spots 1 and 2, respectively, was only moderated according to Tanaka (r = 0.51 and r = 0.55; p < 0.001) and to Kawasaki (r = 0.52 and r = 0.54; p < 0.001). We observed an increasing underestimation of salt consumption by Tanaka to increasing salt consumption and conversely, an overestimation of consumption by the Kawasaki formula. The estimation of salt consumption (difference between measured and calculated salt consumption lower than 1 g/day) was adequate only when the consumption was between 9 -12 g/day (Tanaka) and 12 -18 g/day (Kawasaki). Conclusion: Spot urine sampling is adequate to estimate salt consumption only among individuals with an actual consumption near the population mean.

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“…These findings agreed with our previous results. 13 Chronic administration of diuretics was considered most likely to interfere with the SMU method because these drugs have the strongest natriuretic effect among or the 24-h urine collection method (closed columns). There were no significant differences in the estimated salt intake between the two methods (Wilcoxon's signed-rank test).…”

Section: Discussionmentioning

confidence: 99%

“…The usefulness of the SMU method has been confirmed in population studies 5,11,12 and in hypertensive patients. 13 Although the posture that should be adopted for the SMU method was not specified by the original authors, 10 posture is known to affect the urinary sodium:creatinine ratio 14,15 and could possibly influence the estimation of daily salt intake by this method. Therefore, this study was designed to assess the effect of posture on the estimation of daily salt intake by the SMU method compared with the method of 24-h collection in hospitalized patients with hypertension on a saltrestricted diet.…”

Section: Introductionmentioning

confidence: 99%

The influence of posture on the estimation of daily salt intake by the second morning urine method

et al. 2010

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The second morning urine (SMU) method was developed to evaluate daily salt intake, but the posture that should be adopted until the SMU collection remains unclear. This study investigated the influence of posture in hypertensive patients who underwent this test. The subjects were 100 patients who could collect 24-h urine samples correctly and were on a diet containing 7 g of salt per day. Their daily salt intake was estimated for three consecutive days in the recumbent, sitting, and sitting and standing positions (one posture each day). Estimated salt intake in the recumbent position (10.9±2.4 g day À1 ) was higher than in the sitting position (7.5 ± 2.0 g day À1 ) and the sitting and standing position (6.3 ± 1.7 g day À1 ). The salt intake estimated in the sitting and standing position was similar to that obtained by 24-h urine collection (6.3 ± 1.6 g day À1 ) and was significantly (r¼0.44, Po0.05) correlated with the 24-h urine value. The actual difference in estimated salt intake between the two methods was 0.0 ± 1.7 g day À1 . There were no significant differences in estimated salt intake between the two methods in patients taking different classes of antihypertensive drugs. In conclusion, adopting the sitting and standing position until the SMU collection is important for the correct estimation of daily salt intake, and this method could replace the 24-h collection method because of its convenience, especially in outpatients.

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Effectiveness of a Spot Urine Method in Evaluating Daily Salt Intake in Hypertensive Patients Taking Oral Antihypertensive Drugs

Cited by 49 publications

References 27 publications

Low daily salt intake is correlated with albuminuria in patients with type 2 diabetes

Low daily salt intake is correlated with albuminuria in patients with type 2 diabetes

Estudo de validação das equações de Tanaka e de Kawasaki para estimar a excreção diária de sódio através da coleta da urina casual

The influence of posture on the estimation of daily salt intake by the second morning urine method

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