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Estimating 24-h urinary sodium excretion from casual spot urine specimen among hypertensive patients in Northwest China: the Salt Substitute and Stroke Study

  • Yi Zhao (a1), Wanlu Liu (a1), Sha Liu (a1), Xiaoxia Li (a1), Ting Yin (a1), Xiuying Liu (a1), Faxuan Wang (a1), Xiaoyu Chang (a1), Tianjing Zhang (a2), Maoyi Tian (a3) (a4) and Yuhong Zhang (a1)...

Abstract

Objective:

To develop an equation that can estimate the 24-h urinary Na excretion by using casual spot urine specimen for older hypertensive participants in rural Ningxia and further to compare with the INTERSALT method, Kawasaki method and Tanaka method.

Design:

Older hypertensive participants in rural Ningxia provided their casual spot urine samples and 24-h urine samples between January 2015 and February 2017. Sex-specific equation was developed using linear forward stepwise regression analysis. Model fit was assessed using adjusted R2. Approximately half of all participants were randomly selected to validate the equation. Mean differences, intraclass correlation coefficients and Bland–Altman plots were used to evaluate the performance of all methods.

Setting:

Pingluo County and Qingtongxia County in Ningxia Hui Autonomous Region, China.

Participants:

Older hypertensive participants in rural Ningxia.

Results:

Totally, 807 of 1120 invited participants provided qualified 24-h urine samples and spot urine samples. There was no statistical difference comparing the laboratory-based method against the new method and the INTERSALT method, while Kawasaki method had the largest bias with a mean difference of 40·81 g/d (95 % CI 39·27, 42·35 g/d). Bland–Altman plots showed similar pattern of the results.

Conclusion:

The INTERSALT method and the new equation have the potential to estimate the 24-h urinary Na excretion in this study population. However, the extrapolation of the results to other population needs to be careful. Future research is required to establish a more reliable method to estimate 24-h urinary Na excretion.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Corresponding author: Email zhabour@163.com

Footnotes

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These authors contributed equally to this work.

Footnotes

References

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1.Erdem, Y, Arici, M, Altun, Bet al. (2010) The relationship between hypertension and salt intake in Turkish population: SALTURK study. Blood Press 19, 313318.
2.Ha, SK (2014) Dietary salt intake and hypertension. Electrolyte Blood Press 12, 718.
3.Neal, B (2014) Dietary salt is a public health hazard that requires vigorous attack. Can J Cardiol 30, 502506.
4.D’Elia, L, Galletti, F & Strazzullo, P (2014) Dietary salt intake and risk of gastric cancer. Cancer Treat Res 159, 8395.
5.World Health Organization (2012) Guideline: Sodium Intake for Adults and Children. Geneva, Switzerland: World Health Organization.
6.Mclean, RM (2014) Measuring population sodium intake: a review of methods. Nutrients 6, 46514662.
7.World Health Organization (2011) Strategies to Monitor and Evaluate Population Sodium Consumption and Sources of Sodium in the Diet: Report of a Joint Technical Meeting Convened by WHO and the Government of Canada. Geneva: WHO.
8.Mann, SJ & Gerber, LM (2010) Estimation of 24-hour sodium excretion from spot urine samples. J Clin Hypertens 12, 174.
9.Ortega, RM, Lopez-Sobaler, AM, Ballesteros, JMet al. (2011) Estimation of salt intake by 24 h urinary sodium excretion in a representative sample of Spanish adults. Br J Nutr 105, 787794.
10.Toft, U, Cerqueira, C, Andreasen, AHet al. (2013) Estimating salt intake in a Caucasian population: can spot urine substitute 24-hour urine samples? Eur J Prev Cardiol 21, 13001307.
11.Tanaka, T, Okamura, T, Miura, Ket al. (2002) A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens 16, 97103.
12.Kawasaki, T IK, Uezono, K & Sasaki, H (1993) A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol 20, 7.
13.Brown, IJ, Dyer, AR, Chan, Qet al. (2013) Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations: the INTERSALT study. Am J Epidemiol 177, 11801192.
14.Zhang, T, Chang, X, Liu, Wet al. (2017) Comparison of sodium, potassium, calcium, magnesium, zinc, copper and iron concentrations of elements in 24-h urine and spot urine in hypertensive patients with healthy renal function. J Trace Elem Med Biol 44, 104108.
15.Bruce Neal, MT, Li, N, Elliott, Pet al. (2017) Rationale, design, and baseline characteristics of the Salt Substitute and Stroke Study (SSaSS) – a large-scale cluster randomized controlled trial. Am Heart J 188, 109–107.
16.WHO & PAHO (2010) Protocol for Population Level Sodium Determination in 24-hour Urine Samples. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=21488&Itemid= (accessed October 2018).
17.Whitton, C, Gay, GM, Lim, RBet al. (2016) Evaluation of equations for predicting 24-hour urinary sodium excretion from casual urine samples in Asian adults. J Nutr 146, 16091615.
18.Bland, JM & Altman, DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1, 931936.
19.Kawasaki, T, Ueno, M, Uezono, Ket al. (1982) Average urinary excretion of sodium in 24 hours can be estimated from a spot-urine specimen. Jpn Circ J 46, 948953.
20.Mill, JG, Rodrigues, SL, Baldo, MPet al. (2015) Validation study of the Tanaka and Kawasaki equations to estimate the daily sodium excretion by a spot urine sample. Rev Bras Epidemiol 18, Suppl. 2, 224237.
21.Peng, Y, Li, W, Wang, Yet al. (2016) Validation and assessment of three methods to estimate 24-h urinary sodium excretion from spot urine samples in Chinese adults. PLoS ONE 11, e0149655.
22.Polonia, J, Lobo, MF, Martins, Let al. (2016) Estimation of populational 24-h urinary sodium and potassium excretion from spot urine samples: evaluation of four formulas in a large national representative population. J Hypertens 34, 1.
23.Cogswell, M, Wang, CY, Chen, TCet al. (2013) Validity of predictive equations for 24-h urinary sodium excretion in adults aged 18–39 y. Am J Clin Nutr 98, 15021513.
24.Ji, C, Sykes, L, Paul, Cet al. (2012) Systematic review of studies comparing 24-hour and spot urine collections for estimating population salt intake. Rev Panam Salud Publica 32, 307315.
25.Mercado, CI, Cogswell, ME, Loria, CMet al. (2018) Validity of predictive equations for 24-h urinary potassium excretion based on timing of spot urine collection among adults: the MESA and CARDIA Urinary Sodium Study and NHANES Urinary Sodium Calibration Study. Am J Clin Nutr 108, 532547.
26.Allen, NB, Zhao, L, Loria, CMet al. (2017) The validity of predictive equations to estimate 24-hour sodium excretion: the MESA and CARDIA urinary sodium study. Am J Epidemiol 186, 149.

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Estimating 24-h urinary sodium excretion from casual spot urine specimen among hypertensive patients in Northwest China: the Salt Substitute and Stroke Study

  • Yi Zhao (a1), Wanlu Liu (a1), Sha Liu (a1), Xiaoxia Li (a1), Ting Yin (a1), Xiuying Liu (a1), Faxuan Wang (a1), Xiaoyu Chang (a1), Tianjing Zhang (a2), Maoyi Tian (a3) (a4) and Yuhong Zhang (a1)...

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