A study published in JAMA shows that high sodium intake may increase the risk for cardiovascular disease (CVD) among patients with chronic kidney disease (CKD).
Chronic kidney disease affects approximately 11% of the U.S. population and is associated with increased risk of CVD and all-cause mortality.
This study included 3,757 patients with CKD from seven locations in the United States enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study and were followed up from May 2003 to March 2013. Participants were requested to provide urine specimens at study entry and the first two annual follow-up visits. Among the participants (average age, 58 years; 45% women), 804 composite CVD events (congestive heart failure, stroke, or heart attack) occurred during a median 6.8 years of follow-up.
The researchers found a significantly increased risk of CVD in individuals with the highest urinary sodium excretion independent of several important CVD risk factors, including use of antihypertensive medications and history of CVD. The cumulative incidence of CVD events in the highest quartile of calibrated sodium excretion compared with the lowest was 23.2% versus 13.3% for heart failure, 10.9% versus 7.8% for heart attack, and 6.4% versus 2.7% for stroke at median follow-up. The findings were consistent across subgroups and independent of further adjustment for total caloric intake and systolic blood pressure.
The researchers concluded that, “these findings, if confirmed by clinical trials, suggest that moderate sodium reduction among patients with CKD and high sodium intake may lower CVD risk.”