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Urinary sodium-to-potassium ratio and intake of sodium and potassium among men and women from multiethnic general populations: the INTERSALT Study

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Title: Urinary sodium-to-potassium ratio and intake of sodium and potassium among men and women from multiethnic general populations: the INTERSALT Study
Authors: Iwahori, T
Miura, K
Ueshima, H
Tanaka-Mizuno, S
Chan, Q
Arima, H
Dyer, AR
Elliott, P
Stamler, J
INTERSALT Research Group
Item Type: Journal Article
Abstract: The Na/K ratio may be more strongly related to blood pressure and cardiovascular disease than sodium or potassium. The casual urine Na/K ratio can provide prompt on-site feedback, and with repeated measurements, may provide useful individual estimates of the 24-h ratio. The World Health Organization has published guidelines for sodium and potassium intake, but no generally accepted guideline prevails for the Na/K ratio. We used standardized data on 24 h and casual urinary electrolyte excretion obtained from the INTERSALT Study for 10,065 individuals aged 20-59 years from 32 countries (52 populations). Associations between the casual urinary Na/K ratio and the 24-h sodium and potassium excretion of individuals were assessed by correlation and stratification analyses. The mean 24-h sodium and potassium excretions were 156.0 mmol/24 h and 55.2 mmol/24 h, respectively; the mean 24-h urinary Na/K molar ratio was 3.24. Pearson's correlation coefficients (r) for the casual urinary Na/K ratio with 24-h sodium and potassium excretions were 0.42 and -0.34, respectively, and these were 0.57 and -0.48 for the 24-h ratio. The urinary Na/K ratio predicted a 24-h urine Na excretion of <85 mmol/day (the WHO recommended guidelines) with a sensitivity of 99.7% and 94.0%, specificity of 39.5% and 48.0%, and positive predictive value of 96.3% and 61.1% at the cutoff point of 1 in 24 h and casual urine Na/K ratios, respectively. A urinary Na/K molar ratio <1 may be a useful indicator for adherence to the WHO recommended levels of sodium and, to a lesser extent, the potassium intake across different populations; however, cutoff points for Na/K ratio may be tuned for localization.
Issue Date: 17-Apr-2019
Date of Acceptance: 24-Mar-2019
URI: http://hdl.handle.net/10044/1/69727
DOI: https://dx.doi.org/10.1038/s41440-019-0263-1
ISSN: 0916-9636
Publisher: Springer Nature [academic journals on nature.com]
Journal / Book Title: Hypertension Research
Copyright Statement: © The Japanese Society of Hypertension 2019
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: MR/L01341X/1
Keywords: 24-h urine excretion
Sodium-to-potassium ratio
casual urine
potassium
sodium
INTERSALT Research Group
1103 Clinical Sciences
1102 Cardiorespiratory Medicine and Haematology
Cardiovascular System & Hematology
Publication Status: Published online
Conference Place: England
Embargo Date: 2019-10-17
Online Publication Date: 2019-04-17
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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