Abstract
In order to estimate the salt and potassium intake in a population and to compare their annual trends, we developed a simple method to estimate population mean levels of 24-h urinary sodium (24HUNaV) and potassium (24HUKV) excretion from spot urine specimens collected at any time. Using 591 Japanese data items from the INTERSALT study as a gold standard, we developed formulas to estimate 24-h urinary creatinine (24HUCrV), 24HUNaV and 24HUKV using both spot and 24-h urine collection samples. To examine the accuracy of the formulas, we applied these equations to 513 external manual workers. The obtained formulas were as follows: (1) PRCr (mg/day) = −2.04 × age + 14.89 × weight (kg) + 16.14 × height (cm) − 2244.45; (2) estimated 24HUNaV (mEq/day) = 21.98 × XNa0.392; (3) estimated 24HUKV (mEq/day) = 7.59 × XK0.431; where PRCr = predicted value of 24HUCr, SUNa = Na concentration in the spot voiding urine, SUK = K concentration in the spot voiding urine, SUCr = creatinine concentration in the spot voiding urine, XNa (or XK) = SUNa (or SUK)/SUCr × PRCr. In the external group, there was a significant but small difference between the estimated and measured values in sodium (24.0 mmol/day) and potassium (3.8 mmol/day) excretion. In every quintile divided by the estimated 24HUNaV or 24HUKV, the measured values were parallel to the estimated values. In conclusion, although this method is not suitable for estimating individual Na and K excretion, these formulas are considered useful for estimating population mean levels of 24-h Na and K excretion, and are available for comparing different populations, as well as indicating annual trends of a particular population.
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References
Statistics and Information Department, Minister'sSecretariat, Ministry of Health and Welfare. Vital Statistics, 1965–90, Japan Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare: Tokyo 1965–1990 (in Japanese)
Ueshima H . Changes in dietary habits, cardiovascular risk factors and mortality in Japan Acta Cardiol 1990 45: 311–327
Eastern Stroke and Coronary Heart Disease Collaborative Research Group. Blood pressure, cholesterol, and stroke in eastern Asia Lancet 1998 352: 1801–1807
Ueshima H et al. Alcohol intake and hypertension among urban and rural Japanese populations J Chron Dis 1984 37: 585–592
INTERSALT Cooperative Research Group. Intersalt: an international study of electrolyte excretion and blood pressure. Result for 24 hour urinary sodium and potassium excretion Br Med J 1988 297: 319–328
Rose G, Stamler J on behalf of the INTERSALT Cooperative Research Group. The INTERSALT Study: background, methods and main results J Hum Hypertens 1989 3: 283–288
Elliott P . The INTERSALT study: an addition to the evidence on salt and blood pressure, and some implications J Hum Hypertens 1989 3: 289–298
Elliott P, Dyer A, Stamler R on behalf of the INTERSALT Co-operative Research Group. The INTERSALT study: results for 24 hour sodium and potassium, by age and sec J Hum Hypertens 1989 3: 323–330
Nutrition Section, Ministry of Health and Welfare. National Nutrition Survey, 1998 Daiichi Shuppan: Tokyo 2000 (in Japanese)
Japan Health Promotion and Fitness Foundation. Kenkou Nippon 21 Kouken Shuppan: Tokyo 2000 (in Japanese)
Willett W . Nutritional Epidemiology Oxford University Press: Oxford, UK 1989
Kawasaki T, Itoh K, Uezono K, Sasaki H . A simple method for estimating 24 H urinary sodium and potassium excretion from second morning voiding urine specimen in adults Clin Exp Pharmacol Physiol 1993 20: 7–14
Kawasaki T, Itoh K, Uezono K, Sasaki H . Estimation of 24-hour urinary sodium and potassium excretion from predicted value of 24-hour urinary creatinine excretion and fractional urine sodium/creatinine and potassium/creatinineration. In Seventh Symposium on Salt Vol. 2: Elsevier Science Publishers B.V.: Amsterdam 1993 pp 257–262
The INTERSALT Co-operative Research Group. INTERSALT STUDY. An international co-operative study on the relation of blood pressure to electrolyte excretion in populations. I. Design and methods J Hypertens 1986 4: 781–787
Elliott P, Stamler R in consultation with other investigators of INTERSALT. Manual of operations for ‘INTERSALT’ an international cooperative study on the relation of sodium and potassium to blood pressure Control Clin Trials 1988 9: 1S–118S
Hashimoto T et al. Urinary sodium and potassium excretion, body mass index, alcohol intake and blood pressure in three Japanese populations J Hum Hypertens 1989 3: 315–321
Kawasaki T et al. Studies of urinary creatinine excretion in clinically healthy subjects (1). Influence of age, sex, exercise and amount of salt intake on urinary creatinine excretion and its circadian rhythm J Health Sci Kyushu University 1987 6: 1–8 (in Japanese)
Kawasaki T et al. Studies of urinary creatinine excretion in clinically healthy subjects (2). Establishing of predictive model of 24-hour creatinine excretion in urine – a preliminary report J Health Sci Kyushu University 1984 6: 9–14 (in Japanese)
Kawasaki T et al. Studies of urinary creatinine excretion in clinically healthy subjects. (3). Prediction of 24-hour creatinine excretion in urine from age, body height, body weight and lean body mass J Health Sci Kyushu University 1985 7: 35–42 (in Japanese)
Kawasaki T, Uezono K, Itoh K, Ueno M . Prediction of 24-hour urinary creatinine excretion from age, body weight and height of an individual and its application Jap J Public Health 1991 38: 567–574 (in Japanese)
Kawasaki T et al. Estimation of 24-hour urinary sodium (Na) and potassium (K) excretion from predicted creatinine and Na (or K)/creatinine ratio for second morning voiding urine J Health Sci 1988 10: 115–120 (in Japanese)
Holbrook JT et al. Sodium and potassium intake and balance in adults consuming self-selected diets Am J Clin Nutr 1984 40: 786–793
Mori T et al. Health education using 24-hour urine collection Nippon Koshu Eisei Zasshi 1987 34: 282 (in Japanese)
Tochikubo O, Uneda S, Kaneko Y . Simple portable device for sampling a whole day's urine and its application to hypertensive outpatient Hypertension 1983 5: 270–274
Hirata K et al. A simple method of estimating salt intake by a morning spot urine sampling Igaku no Ayumi 1984 129: 411–416 (in Japanese)
Kawasaki T et al. Renin-angiotensin-aldosterone system and circadian rhythm of urine variables in normotensive and hypertensive subjects Jpn Circ J 1984 48: 168–172
Dossetor JB et al. The diurnal rhythm of urinary excretion. I. Observations in normal subjects Metabolism 1963 12: 1083–1099
Pollack H . Creatinine excretion as index for estimating urinary excretion of micromutrients or their metabolic and products Am J Clin Nutr 1970 23: 865–867
Itoh K, Kawasaki T, Uezono K, Sasaki H . A simple method for estimating 24-hour urinary sodium and potassium excretion from second morning voiding urine specimens J Jap Assoc Cerebro-cardiovas Dis Control 1992 27: 39–45 (in Japanese)
Kawasaki T et al. Studies on estimation of 24-hour urinary sodium excretion from predicted creatinine excretion and fractional urine sodium/creatinine ratio J Health Sci 1986 8: 57–63 (in Japanese)
Acknowledgements
I wish to thank Takehito Hayakawa PhD, and Makoto Watanabe MD, for their advice on this study and thoughtful comments on drafts of this paper. This study was supported in part by a grant from the Ministry of Health and Welfare (H10-kenko -063).
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Tanaka, T., Okamura, T., Miura, K. et al. A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens 16, 97–103 (2002). https://doi.org/10.1038/sj.jhh.1001307
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DOI: https://doi.org/10.1038/sj.jhh.1001307