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Open AccessFeature PaperArticle

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

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Graduate School of Health management, Keio University, Kanagawa 252-0883, Japan
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Department of Health and Nutrition, Tokiwa University of Human Science, Ibaraki 310-8585, Japan
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Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
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Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo 650-0047, Japan
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Faculty of Human Sciences, Tezukayama Gakuin University, Osaka 590-0113, Japan
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Japan Health Insurance Association, Saitama 330-8686, Japan
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Department of Public Health, Hokkaido University Faculty of Medicine, Hokkaido 060-8638, Japan
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Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Hyogo 663-8501, Japan
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Department of Hygiene, Wakayama Medical University, Wakayama 641-8509, Japan
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Center for Epidemiologic Research in Asia Shiga University of Medical Science, Shiga 520-2192, Japan
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Faculty of Nursing and Medical Care, Keio University, Kanagawa 252-0883, Japan
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Department of Clinical Nursing, Shiga University of Medical Science, Shiga 520-2192, Japan
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Open Innovation Center, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(16), 5811; https://doi.org/10.3390/ijerph17165811
Received: 7 July 2020 / Revised: 7 August 2020 / Accepted: 8 August 2020 / Published: 11 August 2020
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. View Full-Text
Keywords: urinary sodium-potassium ratio; urinary sodium; estimated GFR; renal function urinary sodium-potassium ratio; urinary sodium; estimated GFR; renal function
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MDPI and ACS Style

Hattori, H.; Hirata, A.; Kubo, S.; Nishida, Y.; Nozawa, M.; Kawamura, K.; Hirata, T.; Kubota, Y.; Sata, M.; Kuwabara, K.; Higashiyama, A.; Kadota, A.; Sugiyama, D.; Miyamatsu, N.; Miyamoto, Y.; Okamura, T. Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents. Int. J. Environ. Res. Public Health 2020, 17, 5811. https://doi.org/10.3390/ijerph17165811

AMA Style

Hattori H, Hirata A, Kubo S, Nishida Y, Nozawa M, Kawamura K, Hirata T, Kubota Y, Sata M, Kuwabara K, Higashiyama A, Kadota A, Sugiyama D, Miyamatsu N, Miyamoto Y, Okamura T. Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents. International Journal of Environmental Research and Public Health. 2020; 17(16):5811. https://doi.org/10.3390/ijerph17165811

Chicago/Turabian Style

Hattori, Hiroko; Hirata, Aya; Kubo, Sachimi; Nishida, Yoko; Nozawa, Miki; Kawamura, Kuniko; Hirata, Takumi; Kubota, Yoshimi; Sata, Mizuki; Kuwabara, Kazuyo; Higashiyama, Aya; Kadota, Aya; Sugiyama, Daisuke; Miyamatsu, Naomi; Miyamoto, Yoshihiro; Okamura, Tomonori. 2020. "Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents" Int. J. Environ. Res. Public Health 17, no. 16: 5811. https://doi.org/10.3390/ijerph17165811

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