HIGH salt intake could lead to an increased risk of cardiovascular disease (CVD) among chronic kidney disease (CKD) patients, according to a recent study that scrutinised the possible links between urinary sodium excretion and clinical CVD.
As the leading cause of death in the USA, CVD is widely prevalent; more than one-third of adults in this population have the disease. CKD on the other hand affects approximately 11% of people in the USA, a slightly smaller percentage. As it stands, the association between high sodium intake and increased blood pressure has been well established in the medical profession for many years. This study aimed to provide a clearer association between the lesser known links between sodium intake and clinical CVD.
Evaluating a cohort of 3,757 CKD patients from seven locations in the USA who were enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Participants provided urine samples when they entered the study and at the first two annual follow-up visits taking place between May 2003 and March 2013. The participants had an average age of 58 years and 45% were women. During the study, a total of 804 composite CVD events (median 6.8 years of follow-up) took place (congestive heart failure, stroke, or heart attack).
The researchers concluded that there was a significantly heightened risk of CVD in those individuals with the most urinary sodium excretion independent of several important CVD risk factors such as antihypertensive medications and a history of CVD. The data indicated that cumulative incidence at the highest and lowest quartiles of calibrated sodium excretion were 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 the median follow-up.
The findings were presented at this year’s 53rd European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Congress. If confirmed by clinical trials, Prof Jiang He, Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA, suggests that “moderate sodium reduction among patients with CKD and high sodium intake may lower CVD risk.”