The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality in Patients With Type 1 Diabetes
| العنوان: | The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality in Patients With Type 1 Diabetes |
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| المؤلفون: | Nina Tolonen, Lena M. Thorn, Per-Henrik Groop, Merlin C. Thomas, Carol Forsblom, Aila J. Ahola, John Moran, Markku Saraheimo, Daniel Gordin, Johan Wadén, Valma Harjutsalo |
| المصدر: | Diabetes Care |
| بيانات النشر: | American Diabetes Association, 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Population, Renal function, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Excretion, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Cumulative incidence, Prospective Studies, Epidemiology/Health Services Research, Sodium Chloride, Dietary, Prospective cohort study, education, Original Research, Advanced and Specialized Nursing, Type 1 diabetes, education.field_of_study, business.industry, Middle Aged, medicine.disease, 3. Good health, Endocrinology, Diabetes Mellitus, Type 1, Kidney Failure, Chronic, Female, business, Kidney disease |
| الوصف: | OBJECTIVE Many guidelines recommend reduced consumption of salt in patients with type 1 diabetes, but it is unclear whether dietary sodium intake is associated with mortality and end-stage renal disease (ESRD). RESEARCH DESIGN AND METHODS In a nationwide multicenter study (the FinnDiane Study) between 1998 and 2002, 2,807 enrolled adults with type 1 diabetes without ESRD were prospectively followed. Baseline urinary sodium excretion was estimated on a 24-h urine collection. The predictors of all-cause mortality and ESRD were determined by Cox regression and competing risk modeling, respectively. RESULTS The median follow-up for survival analyses was 10 years, during which 217 deaths were recorded (7.7%). Urinary sodium excretion was nonlinearly associated with all-cause mortality, such that individuals with the highest daily urinary sodium excretion, as well as the lowest excretion, had reduced survival. This association was independent age, sex, duration of diabetes, the presence and severity of chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] and log albumin excretion rate), the presence of established cardiovascular disease, and systolic blood pressure. During follow-up, 126 patients developed ESRD (4.5%). Urinary sodium excretion was inversely associated with the cumulative incidence of ESRD, such that individuals with the lowest sodium excretion had the highest cumulative incidence of ESRD. CONCLUSIONS In patients with type 1 diabetes, sodium was independently associated with all-cause mortality and ESRD. Although we have not demonstrated causality, these findings support the calls for caution before applying salt restriction universally. Clinical trials must be performed in diabetic patients to formally test the utility/risk of sodium restriction in this setting. |
| اللغة: | English |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3523a0ff46158def6e0fb5013844c4ffTest http://europepmc.org/articles/PMC3064042Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3523a0ff46158def6e0fb5013844c4ff |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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