Open AccessAssociation between salt intake and long-term mortality in hemodialysis patients: A retrospective cohort study
Author(s) -
Naoki Suzuki,
Yasumasa Hitomi,
Hiroya Takata,
Shinji Ushiya,
Masahiro Yamada,
Yusuke Sakai,
Tenji Konishi,
Yuuki Takeda,
Yuuki Sumino,
Masaya Mizo,
Yoshihiro Tsuji,
Masato Nishimura,
Tsuyoshi Hashimoto,
Hiroyuki Kobayashi
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0260671
Subject(s) - medicine , proportional hazards model , hazard ratio , hemodialysis , body mass index , confounding , cohort study , incidence (geometry) , population , cumulative incidence , cohort , confidence interval , environmental health , physics , optics
Background The association between salt intake and clinical outcomes in hemodialysis patients has been controversial. This study aimed to clarify the association between salt intake and mortality in hemodialysis patients. Method The present study included patients who underwent hemodialysis from June 1st 2016 to May 31st 2020. Corrected salt intake by ideal body weight was the main predictor of outcomes. Ideal body weight was calculated assuming that the ideal body mass index is 22 kg/m 2 for the Japanese population. The multivariate Cox proportional hazards model was used to determine the association between corrected salt intake and mortality, adjusting for potential confounders. The outcomes considered were all-cause mortality and cumulative incidence of cardiovascular events at year 4. Result A total of 492 adult patients were enrolled in the study. The mean daily salt intake and corrected salt intake at baseline were 9.5 g/day and 0.17 g/kg/day, respectively. The low corrected salt intake group (< 0.13 g/kg/day) demonstrated the highest 4-year all-cause mortality. No association was observed between corrected salt intake and the cumulative incidence of cardiovascular events. In multivariate Cox proportional hazards analysis, only the group with corrected salt intake of 0.16–0.20 g/kg/day was associated with a decreased hazard risk for all-cause death compared with the low corrected salt intake group. Conclusion The present study found that a low salt intake was associated with high all-cause mortality in hemodialysis patients. Reduced long-term survival may be attributed to malnutrition resulting from excessive salt restriction.