Rik H Olde Engberink1, Bert-Jan H van den Born2, Hessel Peters-Sengers3, Liffert Vogt4. 1. Department of Internal Medicine, Section of Nephrology, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. r.h.oldeengberink@amsterdamumc.nl. 2. Department of Internal Medicine, Section of Vascular Medicine, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. 3. Center for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres, Amsterdam, the Netherlands. 4. Department of Internal Medicine, Section of Nephrology, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
Abstract
BACKGROUND: High potassium intake has been associated with lower blood pressure and a lower incidence of chronic kidney disease and cardiovascular events. In cohort studies, potassium intake is often estimated with a single 24-h urine collection. However, this may not represent actual long-term individual intake. We assessed whether a single baseline versus multiple follow-up measurements of 24-h urine potassium excretion results in different estimates of individual potassium intake and different associations between potassium intake and long-term outcome. METHODS: We performed a retrospective cohort study in outpatient subjects with an estimated glomerular filtration rate >60 mL/min/1.73 m2 who had sampled a 24-h urine collection at baseline and had ≥1 collection during a 17-year follow-up. Potassium intake was estimated with a single baseline 24-h urine collection but also during 1-year, 5-year, and 15-year follow-up. We used cox regression analysis to assess the association between cardiorenal outcome and estimated potassium intake. RESULTS: Average population (n = 541) 24-h potassium excretion was similar at baseline and follow-up but significant individual changes in potassium intake between baseline and follow-up were observed. Forty-four percent of the subjects switched between tertiles of estimated potassium intake when follow-up measurements were used instead of baseline measurements. Hazard ratios for renal and cardiovascular outcomes were 6.9 and 1.7 times higher when follow-up estimates of potassium intake were replaced by baseline estimates. CONCLUSIONS: Estimated potassium intake and its association with long-term outcome change significantly when multiple follow-ups 24-h urine collections are used for estimation of potassium intake instead of a single baseline measurement.
BACKGROUND: High potassium intake has been associated with lower blood pressure and a lower incidence of chronic kidney disease and cardiovascular events. In cohort studies, potassium intake is often estimated with a single 24-h urine collection. However, this may not represent actual long-term individual intake. We assessed whether a single baseline versus multiple follow-up measurements of 24-h urine potassium excretion results in different estimates of individual potassium intake and different associations between potassium intake and long-term outcome. METHODS: We performed a retrospective cohort study in outpatient subjects with an estimated glomerular filtration rate >60 mL/min/1.73 m2 who had sampled a 24-h urine collection at baseline and had ≥1 collection during a 17-year follow-up. Potassium intake was estimated with a single baseline 24-h urine collection but also during 1-year, 5-year, and 15-year follow-up. We used cox regression analysis to assess the association between cardiorenal outcome and estimated potassium intake. RESULTS: Average population (n = 541) 24-h potassium excretion was similar at baseline and follow-up but significant individual changes in potassium intake between baseline and follow-up were observed. Forty-four percent of the subjects switched between tertiles of estimated potassium intake when follow-up measurements were used instead of baseline measurements. Hazard ratios for renal and cardiovascular outcomes were 6.9 and 1.7 times higher when follow-up estimates of potassium intake were replaced by baseline estimates. CONCLUSIONS: Estimated potassium intake and its association with long-term outcome change significantly when multiple follow-ups 24-h urine collections are used for estimation of potassium intake instead of a single baseline measurement.
Authors: Martin J O'Donnell; Salim Yusuf; Andrew Mente; Peggy Gao; Johannes F Mann; Koon Teo; Matthew McQueen; Peter Sleight; Arya M Sharma; Antonio Dans; Jeffrey Probstfield; Roland E Schmieder Journal: JAMA Date: 2011-11-23 Impact factor: 56.272
Authors: Stanley M H Yeung; Ewout J Hoorn; Joris I Rotmans; Ron T Gansevoort; Stephan J L Bakker; Liffert Vogt; Martin H de Borst Journal: Nutrients Date: 2021-12-17 Impact factor: 5.717
Authors: Stanley M H Yeung; Anne Nooteboom; Ewout J Hoorn; Joris I Rotmans; Liffert Vogt; Rudolf A de Boer; Ron T Gansevoort; Gerjan Navis; Stephan J L Bakker; Martin H De Borst Journal: Am J Clin Nutr Date: 2022-09-02 Impact factor: 8.472