Abstract
The commonly used methods of estimating the 24-h urinary sodium (UNa) and urinary potassium (UK) from spot urine (SU) are the Kawasaki method (K-method), INTERSALT method (I-method), and Tanaka method (T-method), but the method that is suitable for use in the general Chinese population is still uncertain. We aimed to assess and validate these methods in estimating the 24-h UNa and UK using SU samples in Chinese adults. We studied 1428 individuals aged 18–69 years using SU and 24-h urine samples. For the K-method, I-method, and T-method, the Pearson correlation coefficients of the 24-h UNa were 0.35, 0.35, and 0.33 (all p < 0.01), and the intraclass correlation coefficients (ICC) were 0.34, 0.26, and 0.26 (all p < 0.01), respectively. The estimated 24-h UK using the K-method and T-method had correlation coefficients of 0.36 and 0.39 (all p < 0.01) and ICCs of 0.31 and 0.27 (all p < 0.01). The mean bias for the K-method in estimating the 24-h UNa and UK were the least biased among these methods. The bias between the 24-h urine Na/K ratio and the spot urinary Na/K ratio by the Bland–Altman method was −0.22. These methods for estimating the 24-h UNa and UK from SU were inadequate at the population level in Zhejiang Province, although the K-method showed the least bias among these methods. The spot urine Na/K ratio may be a useful and alternative method for 24-h urine collection for the estimation of the urinary Na/K ratio in the Chinese population.
Highlights
Excess sodium intake increases the risk for high blood pressure and is a leading risk factor for cardiovascular disease [1, 2]
Our results showed that the K-method was the least biased among these methods based on the estimation of 24-h urinary sodium (UNa) and UK in Zhejiang Province
Our study showed low correlation between the predicted and measured 24-h UNa, which indicated that the three methods may not be viable for individual sodium excretion estimations
Summary
Excess sodium intake increases the risk for high blood pressure and is a leading risk factor for cardiovascular disease [1, 2]. Reducing dietary salt intake is a vital way to prevent cardiovascular disease and constitutes a potentially important target for the improvement of public health [3]. Limitations of 24-h urinary estimates include high labour costs and low response rates, especially in people who are active and work in manual occupations or occupations that require travelling. These factors affect the practicality of using the test in public health checkups or in population epidemiological surveys. Simple, objective, and standardized methods for measuring sodium and potassium intake at the population level are essential [7]
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