Estimation of daily sodium and potassium excretion from overnight urine of Japanese children and adolescents
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(2020) 25:74
Environmental Health and Preventive Medicine
SHORT COMMUNICATION
Open Access
Estimation of daily sodium and potassium excretion from overnight urine of Japanese children and adolescents Masayuki Okuda1* , Keiko Asakura2 and Satoshi Sasaki3
Abstract Background: Estimates of daily sodium (Na) and potassium (K) excretion were explicitly biased when using equations for adults. We aimed to develop equations to estimate them using overnight urine from Japanese children and adolescents. Methods: The subjects comprised 70 students aged 10.49–15.76 years: validation group, n = 34; and verification group, n = 36. Each subject performed two operations of overnight spot urine (Um) and 24-h urine (U24) sampling. Concentrations of Na, K, and creatinine (Cr) were measured, and anthropometrics were recorded. In the validation group, Na/Cr, and K/Cr (mEq L−1/mg dL−1) in 24-h urine were predicted from their correspondents in overnight urine. Daily Cr excretion (EstCr24; mg d−1) was estimated according to Mage’s method. Results: In validation, we formulated Na excretion (mg d−1) = 23 × exp (0.2085) × [(Na/CrUm + 1)1.0148 − 1] × 1.078 × EstCr24/10; and K excretion (mg d−1) = 39 × exp (0.0315) × [(K/CrUm + 1)1.3165 − 1] × 1.078 × EstCr24/10. For verification, we compared estimates with the measured 24-h Na excretion 3596 ± 1058 mg d−1, and K excretion 1743 ± 569 mg d−1. The mean biases and intraclass correlations (3, 1) were −131 mg d−1 and 0.60, respectively for Na excretion; and −152 mg d−1 and 0.55 for K excretion. Conclusion: We obtained validated equations to estimate daily Na and K excretion with accessible variables such as Na, K, and Cr concentrations of overnight urine, body height and weight, and age for children and adolescents. When using the obtained equations, caution should be paid to small but definite biases and measurement errors. Keywords: Adolescents, Children, Creatinine, Estimation, Excretion, Potassium, Sodium, Urine
Background High sodium (Na) intake is the leading dietary risk factor for death and disability-adjusted life years in East Asia and high-income Asia Pacific regions [1]. The World Health Organization (WHO) recommends reduced sodium intake for children to control blood pressure [2]. Potassium (K) supplementation decreases blood pressure in hypertensive patients with or without antihypertensive * Correspondence: [email protected] 1 Graduate School of Sciences and Technology for Innovation, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan Full list of author information is available at the end of the article
drugs, particularly in high sodium consumers [3]. Na and K have opposite effects on blood pressure. Excess of sodium intake in Japanese is one of the public health challenges targeting children and adolescents as well as adults. Objectively measuring and understanding the salt and potassium consumption of the population is the first step in a public health intervention. However, estimates of Na and K excretion from spot urine of secondary school adolescents u
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