Determinación de sodio urinario como marcador bioquímico para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social, Paraguay

RESUMEN En América Latina, 13% de todas las muertes y 5,1% de los años de vida ajustados por discapacidad se deben a la hipertensión. El exceso de sodio en la dieta puede incrementar aproximadamente un 30% el riesgo de hipertensión. El objetivo fue determinar la concentración de sodio en orina de 24 de horas para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social (MSPBS). Estudio transversal, en trabajadores de 25 a 64 años (n = 397) del MSPBS en Asunción-Paraguay en el 2014. La información sociodemográfica y económica, así como los factores de riesgo de enfermedades cardiovasculares, se evaluaron mediante un cuestionario validado y desarrollado por la OMS. Los niveles de sodio y potasio en orina de 24 horas se midieron usando un protocolo estandarizado. La mediana de la ingesta diaria de sal fue de 13,7 g. La mediana de la excreción de sodio en orina de 24 horas fue de 239 mEq, superando el valor de excreción de sodio recomendado en un 20%. Los hombres tuvieron una excreción de sodio en orina de 24 horas más alta que las mujeres tanto en el grupo de 25 a 44 años (251 mEq / 24 horas frente a 218 mEq/ 24 horas) como en el grupo de 45 a 64 años (266 mEq / 24 horas frente a 233 mEq / 24 horas) de los participantes del estudio. En conclusión, la ingesta de sal fue notablemente superior a la recomendada por la OMS (<5g/d).

ABSTRACT In Latin America, 13% of all deaths and 5.1% of disability-adjusted life years are due to hypertension. An excess of sodium in the diet may increase the risk of hypertension by 30%. The objective was to determine the 24-hour urine sodium concentration to estimate salt intake in employees of the Paraguayan Ministry of Public Health and Social Welfare (MSPBS). Cross-sectional study in 25-64 years-old employees (n=397) of the Ministry of Public Health and Social Welfare in Asuncion-Paraguay in 2014. Socio-demographic and -economic information as well as risk factors of cardiovascular diseases were assessed using a questionnaire validated and developed by the WHO. Sodium and potassium levels in the 24-hour urine were measured using a standardized protocol. The median salt intake per day was 13.7 g. The median of 24-hour urine sodium excretion was 239 mEq, exceeding the recommended sodium excretion value by 20%. Men had a higher 24-hour urine sodium excretion than women in both the 25-44 years-old group (251 mEq/24 hours vs. 218 mEq/24 hours) and the 45-64 years-old segment of the study participants (266 mEq/24 hours vs. 233 mEq/24 hours). In conclusion, salt intake was remarkably higher than recommended by WHO (<5g/d).

Changes of serum sodium and urine sodium of children with febrile seizures and its clinical significance / 中国基层医药

Objective To analyze the changes of the urine sodium and serum sodium in different types and different duration and different temperature in children with febrile seizures,to explore its clinical significance. Methods The children with febrile seizures(n =50)were selected as the group Ⅰ,and the children with fever but without seizure(n =50)were selected as the group Ⅱ,both of them were from pediatric ward.The control group(n =20)without fever or seizure was from Children's Health Section.All the children were checked serum sodium level and urine sodium and urine creatinine level.Results The sodium/creatinine ratio in the groupⅠ[(25.07 ±6.517)] was significantly higher than that in the group Ⅱ[(20.43 ±5.48)]and group Ⅲ[(14.88 ±5.11)](F =33.519, P <0.05),but there was no significant difference of the sodium/creatinine ratio in different ages and different types of the group Ⅰ,and there was negative relevance between the serum sodium and the sodium/creatinine ratio in the groupⅠ(r =-0.517,P <0.05).The mean serum sodium level in the groupⅠ[(133.50 ±3.14)mmol/L]was signifi-cantly lower than that in the group Ⅱ[(137.60 ±2.59)mmol/L]and group Ⅲ[(138.90 ±2.24)mmol/L](F =39.220,P <0.05),but there were no significant differences of the serum sodium in different types and different dura-tion and different temperature of seizure in the group Ⅰ.Conclusion The study shows that serum sodium is lower and the urine sodium is higher in children with febrile seizures,the changes of the urine sodium and serum sodium are not related to the types.The children with febrile seizures should be timely monitoring of serum sodium,urine sodium levels,and according to changes in the level of serum sodium,urine sodium,early appropriate supplement containing sodium liquid and maintaining the blood sodium to normal levels can reduce the recurrence of seizure.

Prediction of Cortical Defect Using C-Reactive Protein and Urine Sodium to Potassium Ratio in Infants with Febrile Urinary Tract Infection

PURPOSE: We investigated whether C-reactive protein (CRP) levels, urine protein-creatinine ratio (uProt/Cr), and urine electrolytes can be useful for discriminating acute pyelonephritis (APN) from other febrile illnesses or the presence of a cortical defect on 99mTc dimercaptosuccinic acid (DMSA) scanning (true APN) from its absence in infants with febrile urinary tract infection (UTI). MATERIALS AND METHODS: We examined 150 infants experiencing their first febrile UTI and 100 controls with other febrile illnesses consecutively admitted to our hospital from January 2010 to December 2012. Blood (CRP, electrolytes, Cr) and urine tests [uProt/Cr, electrolytes, and sodium-potassium ratio (uNa/K)] were performed upon admission. All infants with UTI underwent DMSA scans during admission. All data were compared between infants with UTI and controls and between infants with or without a cortical defect on DMSA scans. Using multiple logistic regression analysis, the ability of the parameters to predict true APN was analyzed. RESULTS: CRP levels and uProt/Cr were significantly higher in infants with true APN than in controls. uNa levels and uNa/K were significantly lower in infants with true APN than in controls. CRP levels and uNa/K were relevant factors for predicting true APN. The method using CRP levels, u-Prot/Cr, u-Na levels, and uNa/K had a sensitivity of 94%, specificity of 65%, positive predictive value of 60%, and negative predictive value of 95% for predicting true APN. CONCLUSION: We conclude that these parameters are useful for discriminating APN from other febrile illnesses or discriminating true APN in infants with febrile UTI.

Associations between 24-hour Urine Sodium Excretion Level and Obesity-related Metabolic Risk Factors / 대한지역사회영양학회지

OBJECTIVES: Excess sodium intake has been linked to obesity and obesity-related indices. However, the scientific evidence for this association is inadequate. The purpose of this study was to investigate the association between urinary sodium excretion and obesity-related indices among Korean adults. METHODS: A convenience sample of 120 subjects (60 obese and 60 non-obese subjects) were recruited applying frequency matching for sex and age between two groups. Sodium intake level was assessed through 24-hour urine collection. Obesity-related metabolic risk factors, including fasting blood lipid indices, subcutaneous and visceral fat through computed tomography (CT), insulin resistance indices, blood pressure and liver enzymes were measured in all subjects. These obesity-related metabolic risk factors were compared between obese and non-obese group according to sodium excretion levels (180 mEq/day). RESULTS: After adjusting for age, gender, health behaviors (smoking, exercise, drinking), and energy intake, several obesity-related metabolic risk factors, including abdominal circumference, body fat percentage, subcutaneous and visceral fat, triglyceride, and systolic blood pressure were found to be significantly deteriorated as the sodium excretion level increases. In addition, multivariate adjusted-odds ratios of abdominal obesity, high blood triglyceride, and high blood pressure were found significantly higher in the highest sodium excretion group compared to the lowest group. The mean number of metabolic syndrome risk factors was also significantly greater in the highest sodium excretion group than in the lowest group. CONCLUSIONS: The current study findings suggested that high sodium intake can affect obesity and metabolic syndrome risk negatively, implying the necessity of future research on low-sodium diet intervention in relation to obesity and related health problems.

Estimated Amount of 24-Hour Urine Sodium Excretion Is Positively Correlated with Stomach and Breast Cancer Prevalence in Korea

Stomach cancer is one of the most common cancers in Korea. The aim of this study was to identify the association between the prevalence of cancer, particularly stomach cancer, and the amount of 24-hr urine sodium excretion estimated from spot urine specimens. The study included 19,083 subjects who took part in the Korean National Health and Nutritional Examination Survey between 2009 and 2011. The total amount of urine sodium excreted in a 24-hr period was estimated by using two equations based on the values for spot urine sodium and creatinine. In subjects who had an estimated 24-hr urine sodium excretion of more than two standard deviations above the mean (group 2), the prevalence of stomach cancer was higher than in subjects with lower 24-hr sodium excretion (group 1). By using the Tanaka equation to estimate it, the prevalence of stomach cancer was 0.6% (114/18,331) in group 1, whereas it was 1.6% (9/568) in group 2 (P=0.006). By using the Korean equation, the prevalence was 0.6% (115/18,392) in group 1, and 1.6% in group 2 (8/507) (P=0.010). By using the Tanaka equation, breast cancer in women is more prevalent in group 2 (1.9%, 6/324) than group 1 (0.8%, 78/9,985, P=0.039). Higher salt intake, as defined by the estimated amount of 24-hr urine sodium excretion, is positively correlated with a higher prevalence of stomach or breast cancer in the Korean population.

Estimating 24-Hour Urine Sodium Level with Spot Urine Sodium and Creatinine

The 24-hr urine sodium excretion level was estimated based on the spot urine sodium, and the efficacy of the formula was validated to determine the status of low salt intake or =100 mEq/day using the estimated amount> or =100 mEq/day was 84.3%, 87.6%, and 84.8%, respectively. In conclusion, the three equations used to estimate the 24-hr urine sodium content were useful to determine the status of low salt intake.

Evaluation of Blood Volume State Using the Quotient of Urine Sodium and Potassium Excretion in Primary Nephrotic Syndrome in Children

PURPOSE: Edema is one of the cardinal features of nephrotic syndrome. Although the pathogenesis of edema is not entirely understood, it is caused by hypovolemia or hypervolemia by different mechanisms. Accordingly it is important to evaluate the volume status of patients in order to treat the edema, but it is difficult to evaluate the patient's volume status only by clinical parameters. The quotient of urine sodium and potassium excretion UK/(UNa+UK) is introduced as a more useful way to evaluate volume status. In this study we will propose the usefulness of UK/(UNa+UK) in evaluating the volume status of children with nephrotic syndrome. METHODS: Primary nephrotic syndrome patients at Yeungnam University Hospital since January 1995 to June 2005, were included in the study. We analyzed clinical parameters such as tachycardia, cardiomegaly, pleural effusion, blood chemistry and urinalysis prospectively. We defined hypovolemia when UK/(UNa+UK) exceeded 60%. Intravenous albumin and diuretics were administered to hypovolemic edematous patients. On the other hand, hypervolemic edematous patients were treated only with diuretics. RESULTS: There were 50 cases of primary nephrotic syndrome patients(hypervolemia: 29 vs hypovolemia: 21). There were no significant differences in clinical symptoms and laboratory findings except for FeNa. While FeNa and UK/(UNa+UK) had a significant negative correlation, BUN and UK/(UNa+UK) had a significant positive correlation. Urine output after edema treatment was effective and there were no treatment-related side effects in both groups. CONCLUSION: FeNa, BUN and UK/(UNa+UK) are a useful parameters for evaluating volume status of edematous nephrotic syndrome patients. We could suggest a therapeutic option for using albumin and/or diuretics according to volemic status by means of measured UK/(UNa+UK).

A statistical study on obesity, blood pressure, serum total cholesterol, serum apolipoprotein B and urine sodium and potassium in middle school children

No abstract available.

A Comparative Study on the Daily Excretion of Urinary Sodium, Potassium and Volume Between Urban and Rural Korean / 대한비뇨기과학회지

Author had already reported that urinary excretions of several electrolytes of rural Korean measured in late 1970`s were different with that of the 1960`s. This study was carried out to evaluate the difference of daily urine volume, urinary excretions of sodium and potassium between urban and rural residents in Korea. 20 urban and 28 rural residents were selected arbitrarily and the surface areas of both group didn`t show any difference. 24 hour urines were collected and sodium and potassium concentrations were analyzed by means of flame photometry. Followings were the results. 1. Daily urine volume urban residents: 1578.75 461.92 ml/day, rural residents: 1582.14 417.91 ml/day 2. Daily urinary sodium excretion urban residents: 223.95 109.61 mEq/day, rural residents: 219.68 65.60 mEq/day 3. Daily urinary potassium excretion urban residents: 75.44 28.00 mEq/day, rural residents: 49.52 14.95 mEq/day Above results reveal that daily urine volume and urinary excretion of sodium of urban residents are within the range of rural residents, while daily urinary potassium excretion of urban are much higher than that of rural one. In addition, the ratio of K/Na of urban residents is also much higher than that of rural residents and than that of 1960`s, although the ratio was still lower than those of Westerns.

A Comparative Study on the Daily Excretion of Urinary Sodium, Potassium and Volume Between Urban and Rural Korean / 대한비뇨기과학회지

Author had already reported that urinary excretions of several electrolytes of rural Korean measured in late 1970`s were different with that of the 1960`s. This study was carried out to evaluate the difference of daily urine volume, urinary excretions of sodium and potassium between urban and rural residents in Korea. 20 urban and 28 rural residents were selected arbitrarily and the surface areas of both group didn`t show any difference. 24 hour urines were collected and sodium and potassium concentrations were analyzed by means of flame photometry. Followings were the results. 1. Daily urine volume urban residents: 1578.75 461.92 ml/day, rural residents: 1582.14 417.91 ml/day 2. Daily urinary sodium excretion urban residents: 223.95 109.61 mEq/day, rural residents: 219.68 65.60 mEq/day 3. Daily urinary potassium excretion urban residents: 75.44 28.00 mEq/day, rural residents: 49.52 14.95 mEq/day Above results reveal that daily urine volume and urinary excretion of sodium of urban residents are within the range of rural residents, while daily urinary potassium excretion of urban are much higher than that of rural one. In addition, the ratio of K/Na of urban residents is also much higher than that of rural residents and than that of 1960`s, although the ratio was still lower than those of Westerns.

Studies on Urinary Excretions of Sodium, Potassium and Urea Nitrogen and Urine Volume for 24 Hours in Rural Korean / 대한비뇨기과학회지

Daily excretions of sodium, potassium and urea nitrogen and urine volume of normal Korean were reported by several authors. However, it is generally suspected that dietary composition of Koreans improved during last decade. Author have hypothetized that changes of diet composition could modify urine compositions and volume. In order to determine the urine composition and volume in the late 1970`s, sodium and potassium concentrations were measured by flame photometry and urea nitrogen by urease indophenol method in the urine from 50 rural residents. The residents were composed of 10 public officials, 18 male farmers and 22 female farmers. Followings were the results: 1. Daily urine volume Total average : 1594.20+/-443.89 ml/day, Public official : 1714.00+/-548.00 ml/day Male farmer :1508.89+/-310. 54ml/day, Female farmer: 1612.27+/-496.04 ml/day 2. Daily urinary sodium excretion Total average : 5.19+/-1.21 g/day. Public official : 5.62+/-1.93 g/day Male farmer : 4.73+/-1.10 g/day, Female farmer: 5.37+/-0.98 g/day 3. Daily urinary potassium excretion Total average : 1.79+/-0.59 g/day, Public official : 1.97+/-0.60 g/day Male farmer : 1.91+/-0.59 g/day, Female farmer : 1.62+/-0.58 g/day 4. Daily urinary urea nitrogen excretion Total average : 7.26+/-l.95 g/day, Public official : 8.06+/-1.65 g/day Male farmer: 7.53+/-2.40 g/day. Female farmer : 6.67+/-1.65 g/day A comparison of these data with corresponding figures obtained from Western reporters indicate that the concentration and excretion of sodium of rural Koreans are still higher significantly, while those of potassium and urea nitrogen are lower than those of Westerns significantly. On the other hand, a comparison with corresponding figures obtained from other Korean reporters in the 1960's indicate that sodium excretion of present data is lower while potassium and urea nitrogen are higher than those of the 1960's. It is speculated that these peculiarities of urinary composition shown in rural Koreans in the late 1970's are attributed to improved protein ingestion combined with decreased salt intake as compared to 1960's, however, the levels are still far from Westerns.