Urinary sodium excretion patterns in adult population in spot urine samples
DOI:
https://doi.org/10.18004/anales/2017.050(01)51-060Keywords:
natriuresis, low-salt diet, high blood pressure, lifestyle, ParaguayAbstract
Introduction: The present study describes natriuresis patterns according to clinical and sociodemographic characteristics in adult population of Asuncion. Methods: Cross-sectional study of convenience sampling to people who attended the Mercado de Abasto and the Municipal Polyclinic during June to September 2014. People from 18 to 65 years old were included. Sodium was estimated from urine samples of spot urine taken in the morning and fasting. Median values of natriuresis in mmol/L were compared using the test Mann-Whitney and Kruskal-Wallis. Results: 463 people participated. 69.5% (322) were women. The mean age was 50.5 years (SD 14.2). 26.6% (123) denied pathological medical history. The median overall natriuresis was 97.5 mmol/L (IQR: 59.3-139.3). Natriuresis levels did not differ by sex. High values with statistically significant were presented in people under 30 years old, with low consumption of vegetables and increased consumption of fried food. The group of healthy subjects showed increased sodium excretion than those who reported diabetes or high blood pressure. Conclusions: The increased natriuresis occurs in young people without having pathological medical history and also having the worst eating habits. Public health policies must focus at this level to prevent future cardiovascular and renal disease it is at this level where public health must intervene to prevent future cardiovascular and renal disease.
References
1. Alderman MH. Evidence relating dietary sodium 1. to cardiovascular disease. J Am Coll Nutr. 2006; 25(S3):S256-S261.
2. Titze J, Ritz E. J Salt and its effect on blood pressure and target organ damage: New pieces in an old puzzle. Nephrol. 2009 Mar-Apr;22(2):177-89
3. Hypertension: an urgent need for global control and prevention. Lancet. 2014 May 31;383(9932): 1861.
4. Bürgi H, Zimmermann MB. Salt as a carrier of iodine in iodine deficient areas. Schweiz Monatsschr Zahnmed. 2005;115(8):648-50.
5. Lozada M, Sánchez-Castillo CP, Cabrera GA, 5. Mata II, Pichardo-Ontiveros E, James WP. Salt: its goodness and perversities. Rev Invest Clin. 2007 Sep-Oct;59(5):382-93
6. Albala C, Vio F, Kain J, Uauy R. Nutrition transition in Chile: determinants and consequences. Public Health Nutr 2002;5:123-128.
7. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord. 2004 Nov;28 Suppl 3:S2-9.
8. Ramirez MO, Pino CT, Furiasse LV, Lee AJ, Fowkes FG. Paraguayan National Blood Pressure Study: prevalence of hypertension in the general population. J Hum Hypertens. 1995 Nov;9(11):891-7.
9. Encuesta Nacionald de Factores de Riesgos y Enfermedades No transmisibles 2011. MSPyBS, Paraguay. ISBN:978-99967-36-16-2. Disponible: http://www.mspbs.gov.py
10. Pedrozo ME, Assis D, Cabello A, Cañete F, Prieto F, Barengo N. Determinación de sodio urinario como marcador bioquímico para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social, Paraguay-2014. [Pendiente Publicación]
11. Grupo De Expertos De La Oms/Ops Sobre La Prevención De Las Enfermedades Cardiovasculares Mediante La Reducción De La Ingesta De Sal Alimentaria De Toda La Población. PAHO, 2011. Accesible en: http://www.paho.org/
12. Bisi M MC, Cunha R de Sá; Herkenhoff LE Hipertensão arterial e consumo de sal em população urbana. Rev Saúde Pública 2003;37:743-750.
13. Rhee MY, Kim JH, Shin SJ, Gu N, Nah DY, Hong KS, Cho EJ, Sung KC. Estimation of 24-hour urinary sodium excretion using spot urine samples. Nutrients. 2014 Jun 20;6(6):2360-75.
14. Bernstein A, Willett W. Trends in 24-h urinary sodium excretion in the United States, 1957–2003: a systematic review. Am J Clin Nutr. 2010 Nov; 92(5): 1172–1180.
15. Sanchez-Castello CP, Warrender 5, Whitehead TP, James WPT. An assessment of the sources of di etary salt in a British population. Clin Sci 1987;72:95-102)
16. Mattes RD. Donnelly D. Relative contributions of dietary sodium sources. J Am Coll Nutr 1991: 10: 383-393.
17. Mann SJ, Gerber LM. Estimation of 24-hour sodium excretion from spot urine samples. J Clin Hypertens (Greenwich). 2010 Mar;12(3):174-80.
18. Toft U, Cerqueira C, Andreasen AH, Thuesen BH, Laurberg P, Ovesen L, Perrild H, Jørgensen T. Estimating salt intake in a Caucasian population: can spot urine substitute 24-hour urine samples? Eur J Prev Cardiol. 2014 Oct;21(10):1300-7.
19. McLean R, Williams S, Mann J. Monitoring population sodium intake using spot urine samples: validation in a New Zealand population. J Hum Hypertens. 2014 Nov;28(11):657-62.
20. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013 Apr 3;346:f1326.
21. Survey on Members States’ Implementation of the EU Salt Reduction Framework. Accesible en: http://ec.europa.eu
22. Cappuccio FP, Capewell S, Lincoln P et al. (2011) Policy options to reduce population salt intake. BMJ 343, d4995.
23. Rose G. Sick individuals and sick populations. Int J Epidemiol. 1985 Mar;14(1):32-8.
24. Boletin de Enfermedades No Transmisibles 2015. DVENT, MSPyBS- Paraguay. Disponible en: http://www.mspbs.gov.py
