METHODS: Primary care data from the Royal College of General Practitioners Research and Surveillance Centre were used to identify 47,294 individuals with a UACR result available between April 2010 and March 2015, and no known albuminuria prior to this. Exclusion criteria were missing or abnormal serum sodium concentration at baseline (<135 or >146 mmol/L); age <18 years; diabetes mellitus; decompensated liver disease; heart failure; and stage 5 chronic kidney disease.
RESULTS: After adjustment for known risk factors, there was a significant \"U-shaped\" relationship between serum sodium concentration and albuminuria. The lowest risk was associated with a serum sodium of 138-140 mmol/L. In comparison, the risk of albuminuria was 18% higher with a serum sodium of 135-137 mmol/L and 19% higher with a serum sodium of 144-146 mmol/L. There was no association between serum sodium concentration and blood pressure.
CONCLUSIONS: The finding of a positive association between higher serum sodium concentration and albuminuria is in support of the hypothesis, but the inverse relationship between serum sodium concentration and albuminuria at lower concentrations warrants further explanation.
方法:使用来自皇家全科医师研究和监测中心的初级保健数据,在2010年4月至2015年3月期间,有47,294名UACR结果的个体被用于鉴定,在此之前没有已知的白蛋白尿。排除标准为:基线血清钠浓度缺失或异常(<135或146mmol/L);年龄18岁;糖尿病;失代偿性肝病;心力衰竭;和5期慢性肾病。
结果:对已知风险因素进行调整后,血清钠浓度与白蛋白尿之间存在显著的U型关系。最低的风险与138-140mmol/L的血清钠有关。相比之下,血清钠为135-137mmol/L时,白蛋白尿的风险增加18%,血清钠为144-146mmol/L时,白蛋白尿的风险增加19%。血清钠浓度与血压之间没有相关性。
结论:血清钠浓度升高与白蛋白尿呈正相关的发现支持了这一假设,但在较低浓度时,血清钠浓度与白蛋白尿之间的反比关系值得进一步解释。