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- Title
Self-Reported Frequency of Adding Salt to Food and Risk of Incident Chronic Kidney Disease.
- Authors
Tang, Rui; Kou, Minghao; Wang, Xuan; Ma, Hao; Li, Xiang; Heianza, Yoriko; Qi, Lu
- Abstract
This cohort study examines whether frequency of adding salt to food as determined by self-report is associated with increased risk of chronic kidney disease (CKD). Key Points: Question: Is self-reported frequency of adding salt to food associated with increased risk of chronic kidney disease (CKD) in the general population, and if so, is there any modification by other risk factors? Findings: In this cohort study involving 465 288 participants from the UK Biobank, a higher self-reported frequency of adding salt to foods was significantly associated with an increased risk of CKD. The associations were more pronounced among participants with a higher estimated glomerular filtration rate and lower body mass index or physical activity level. Meaning: These findings suggest that adding salt to foods is associated with increased risk of CKD in the general population, emphasizing the possible value of limiting discretionary salt to reduce CKD risk. Importance: The self-reported frequency of adding salt to foods could reflect a person's long-term salt taste preference, and salt intake has been associated with increased risk of cardiovascular diseases (CVD). Whether self-reported adding of salt to foods is associated with increased risk of chronic kidney disease (CKD) remains unknown. Objective: To prospectively examine the association of self-reported frequency of adding salt to foods with incident CKD risk in a general population of adults. Design, Setting, and Participants: This population-based cohort study evaluated UK Biobank participants aged 37 to 73 years who were free of CKD at baseline. Participants were enrolled from 2006 to 2010 and prospectively followed up for disease diagnosis. Data were analyzed from October 2022 to April 2023. Exposure: Self-reported frequency of adding salt to foods, categorized into never or rarely, sometimes, usually, and always. Main Outcome and Measure: Incident CKD cases were defined by diagnostic codes. Hazard ratios (HRs) and 95% CIs were calculated by using Cox proportional hazards models. Models were adjusted for several potential confounders including age, sex, race and ethnicity, Townsend Deprivation Index, estimated glomerular filtration rate (eGFR), body mass index, (BMI), smoking status, alcohol drinking status, regular physical activity, high cholesterol, diabetes, CVD, hypertension, infectious disease, immune disease, and nephrotoxic drugs use at baseline. Results: Within a cohort of 465 288 individuals (mean [SD] age 56.32 [8.08] years; 255 102 female participants [54.83%]; 210 186 male participants [45.17%]), participants with higher self-reported frequency of adding salt to foods were more likely to have a higher BMI, higher Townsend Deprivation Index score, and diminished baseline eGFR compared with those who reported a lower frequency of adding salt to foods. Participants who added salt to their foods were also more likely than those who did not add salt to their foods to be current smokers and have diabetes or CVD at baseline. During a median (IQR) follow-up of 11.8 (1.4) years, 22 031 incident events of CKD were documented. Higher self-reported frequency of adding salt to foods was significantly associated with a higher CKD risk after adjustment for covariates. Compared with those who reported never or rarely adding salt to foods, those who reported sometimes adding salt to food (adjusted HR [aHR], 1.04; 95% CI, 1.00-1.07), those who reported usually adding salt to food (aHR, 1.07; 95% CI, 1.02-1.11), and those who reported always adding salt to food (aHR, 1.11; 95% CI, 1.05-1.18) had an increased risk of CKD (P for trend <.001). In addition, eGFR, BMI, and physical activity significantly modified the associations, which were more pronounced among participants with a higher eGFR, lower BMI, or lower level of physical activity. Conclusions and Relevance: In this cohort study of 465 288 individuals, a higher self-reported frequency of adding salt to foods was associated with a higher risk of CKD in the general population. These findings suggest that reducing the frequency of adding salt to foods at the table might be a valuable strategy to lower CKD risk in the general population.
- Subjects
UNITED Kingdom; CHRONIC kidney failure; GLOMERULAR filtration rate; HYPERTENSION; NEPHROTOXICOLOGY; ACADEMIC medical centers; CONFIDENCE intervals; COMMUNICABLE diseases; SELF-evaluation; HYPERCHOLESTEREMIA; DIABETES; CARDIOVASCULAR diseases; AUTOIMMUNE diseases; RISK assessment; PHYSICAL activity; SOCIOECONOMIC factors; QUESTIONNAIRES; KAPLAN-Meier estimator; ALCOHOL drinking; DESCRIPTIVE statistics; RESEARCH funding; SMOKING; DATA analysis software; BODY mass index; DIETARY sodium; LONGITUDINAL method; PROPORTIONAL hazards models; DISEASE risk factors; ADULTS
- Publication
JAMA Network Open, 2023, Vol 6, Issue 12, pe2349930
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.49930