Open AccessHigh dietary potassium blunts dietary sodium induced proteinuria
Author(s) -
Ogu Iheanyichukwu,
Khitan Zeid J.
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13394
Subject(s) - proteinuria , medicine , potassium , sodium , renal function , cohort , endocrinology , aldosterone , low sodium , renin–angiotensin system , blood pressure , urology , kidney , chemistry , organic chemistry
To the Editor, The association of high sodium intake with proteinuria and hyper‐ tension is well established. Also, potassium intake has been shown to be associated with lower blood pressure in people on high salt diet1 and correlates negatively with proteinuria.2 In this report we sought to evaluate the influence of dietary potassium on the renal function effect of sodium intake by studying the relationship between dietary potassium, dietary sodium intake, and urinary protein excretion. We performed analysis on the baseline data of the National Institute of Health‐funded Modification of Diet in Renal Disease (MDRD) study. We used SPSS version 24 (IBM Armonk NY) for statistical analysis. Using the entire MDRD cohort, we performed bivariate correlation (Pearson) between dietary sodium as the pre‐ dictor and proteinuria as the dependent variable. We then repeated the analysis by including 10% of the cohort that had the highest di‐ etary potassium intake. As expected, our results showed significant correlation between dietary sodium and proteinuria in all subjects (n = 13 813, Pearson correlation = 0.062, P < 0.001) but this cor‐ relation lost statistical significance when only top 10% of the co‐ hort with highest potassium intake was analyzed (n = 1423, Pearson correlation = 0.034, P = 0.20). Our study highlights an important association between high dietary potassium and reduction in proteinuria induced by dietary sodium. Sodium intake is associated with proteinuria and can impair the antiproteinuric effect of renin‐angiotensin‐aldosterone system (RAAS) blockers which are commonly used to reduce proteinuria and improve renal outcome.3 Oral potassium loading can suppress renin activity, induce natriuresis, negative sodium balance and decrease blood pressure.4,5 These mechanisms may be important in the anti‐ proteinuric effect of potassium. This is a cross‐sectional study and so can only make inference to an association. Further studies are required to fully evaluate this relationship and its potential benefits.