Urinary Sodium-To-Potassium Ratio Is A Dual Indicator Of Hypertension And Current Disease Activity In Patients With Rheumatoid Arthritis: A Cross-Sectional Study In The KURAMA Cohort Database
Background: Excessive salt intake is thought to exacerbate both development of hypertension and autoimmune diseases in animal models, but the clinical impact of excessive salt in rheumatoid arthritis (RA) patients is still unknown. We performed a cross-sectional study to clarify the associations between salt load index (urinary sodium-to-potassium ratio (Na/K ratio)), current disease activity and hypertension in an RA population.
Methods: Three hundred thirty-six participants from our cohort database (KURAMA) were enrolled. We used the spot urine Na/K ratio as a simplified index of salt loading, and used the 28-Joint RA Disease Activity Score (DAS28-ESR) as an indicator of current RA disease activity. Using these indicators, we evaluated statistical associations between urinary Na/K ratio, DAS28-ESR and prevalence of hypertension.
Results: Urinary Na/K ratio was positively associated with measured systolic and diastolic blood pressure and also with prevalence of hypertension even after covariate adjustment (OR 1.30, p < 0.001). In addition, increased urinary Na/K ratio was significantly and positively correlated with DAS28-ESR in multiple regression analysis (estimate 0.12, p < 0.001), as was also the case in gender-separated and prednisolone-separated sub-analyses.
Conclusion: Urinary Na/K ratio was independently associated with current disease activity as well as with prevalence of hypertension in RA patients. Thus, dietary modifications such as salt restriction and potassium supplementation may well attenuate both disease activity and hypertension in RA patients.
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Posted 21 Dec, 2020
On 16 Jan, 2021
On 16 Jan, 2021
Invitations sent on 24 Dec, 2020
On 15 Dec, 2020
On 15 Dec, 2020
On 15 Dec, 2020
On 14 Dec, 2020
Urinary Sodium-To-Potassium Ratio Is A Dual Indicator Of Hypertension And Current Disease Activity In Patients With Rheumatoid Arthritis: A Cross-Sectional Study In The KURAMA Cohort Database
Posted 21 Dec, 2020
On 16 Jan, 2021
On 16 Jan, 2021
Invitations sent on 24 Dec, 2020
On 15 Dec, 2020
On 15 Dec, 2020
On 15 Dec, 2020
On 14 Dec, 2020
Background: Excessive salt intake is thought to exacerbate both development of hypertension and autoimmune diseases in animal models, but the clinical impact of excessive salt in rheumatoid arthritis (RA) patients is still unknown. We performed a cross-sectional study to clarify the associations between salt load index (urinary sodium-to-potassium ratio (Na/K ratio)), current disease activity and hypertension in an RA population.
Methods: Three hundred thirty-six participants from our cohort database (KURAMA) were enrolled. We used the spot urine Na/K ratio as a simplified index of salt loading, and used the 28-Joint RA Disease Activity Score (DAS28-ESR) as an indicator of current RA disease activity. Using these indicators, we evaluated statistical associations between urinary Na/K ratio, DAS28-ESR and prevalence of hypertension.
Results: Urinary Na/K ratio was positively associated with measured systolic and diastolic blood pressure and also with prevalence of hypertension even after covariate adjustment (OR 1.30, p < 0.001). In addition, increased urinary Na/K ratio was significantly and positively correlated with DAS28-ESR in multiple regression analysis (estimate 0.12, p < 0.001), as was also the case in gender-separated and prednisolone-separated sub-analyses.
Conclusion: Urinary Na/K ratio was independently associated with current disease activity as well as with prevalence of hypertension in RA patients. Thus, dietary modifications such as salt restriction and potassium supplementation may well attenuate both disease activity and hypertension in RA patients.
Figure 1
Figure 2