Estimation of potassium intake: single versus repeated measurements and the associated cardiorenal risk
- 15 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Nutrition
- Vol. 76 (2), 309-316
- https://doi.org/10.1038/s41430-021-00951-0
Abstract
Background High potassium intake has been associated with lower blood pressure and a lower incidence of chronic kidney disease and cardiovascular events. In cohort studies, potassium intake is often estimated with a single 24-h urine collection. However, this may not represent actual long-term individual intake. We assessed whether a single baseline versus multiple follow-up measurements of 24-h urine potassium excretion results in different estimates of individual potassium intake and different associations between potassium intake and long-term outcome. Methods We performed a retrospective cohort study in outpatient subjects with an estimated glomerular filtration rate >60 mL/min/1.73 m2 who had sampled a 24-h urine collection at baseline and had ≥1 collection during a 17-year follow-up. Potassium intake was estimated with a single baseline 24-h urine collection but also during 1-year, 5-year, and 15-year follow-up. We used cox regression analysis to assess the association between cardiorenal outcome and estimated potassium intake. Results Average population (n = 541) 24-h potassium excretion was similar at baseline and follow-up but significant individual changes in potassium intake between baseline and follow-up were observed. Forty-four percent of the subjects switched between tertiles of estimated potassium intake when follow-up measurements were used instead of baseline measurements. Hazard ratios for renal and cardiovascular outcomes were 6.9 and 1.7 times higher when follow-up estimates of potassium intake were replaced by baseline estimates. Conclusions Estimated potassium intake and its association with long-term outcome change significantly when multiple follow-ups 24-h urine collections are used for estimation of potassium intake instead of a single baseline measurement.Keywords
Funding Information
- Nierstichting (CP16.01)
This publication has 17 references indexed in Scilit:
- Agreement Between 24-Hour Salt Ingestion and Sodium Excretion in a Controlled EnvironmentHypertension, 2015
- The relationship between estimated sodium and potassium excretion and subsequent renal outcomesKidney International, 2014
- Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular EventsThe New England Journal of Medicine, 2014
- Association between Dietary Sodium and Potassium Intake with Chronic Kidney Disease in US Adults: A Cross-Sectional StudyAmerican Journal of Nephrology, 2013
- Long-Term Space Flight Simulation Reveals Infradian Rhythmicity in Human Na+ BalanceCell Metabolism, 2013
- New primary renal diagnosis codes for the ERA-EDTANephrology Dialysis Transplantation, 2012
- Urinary Sodium and Potassium Excretion and Risk of Cardiovascular EventsJAMA, 2011
- Urinary Potassium Is a Clinically Useful Test to Detect a Poor Quality DietJournal of Nutrition, 2009
- Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trialsJournal of Human Hypertension, 2003
- Effects of Oral Potassium on Blood PressureJAMA, 1997