Association of dietary sodium and potassium intakes with albuminuria in normal-weight, overweight, and obese participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Background: Among obese adults, sodium intake has been associated with cardiovascular disease. Few data are available on sodium intake and albuminuria, a marker of kidney damage and risk factor for cardiovascular disease. Objective: We examined the relation between dietary sodium and potassium intakes and the ratio of sodium to potassium (Na/K) with albuminuria by BMI in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study (n = 30,239 adults aged >= 45 y). Design: A modified Block 98 food-frequency questionnaire was used for dietary assessment in 21,636 participants, and nutritional variables were categorized by sex-specific quintiles. Normal weight, overweight, and obese were defined as BMI (in kg/m(2)) categories of 18.5-24.9, 25-29.9, and >= 30, respectively. Albuminuria was defined as a ratio (mg/g) of urinary albumin to creatinine of >= 30. Results: The prevalences of albuminuria were 11.5%, 11.6%, and 16.0% in normal-weight, overweight, and obese participants, respectively. The multivariable-adjusted ORs for albuminuria in a comparison of the highest with the lowest quintile of Na/K intake (>= 1.12 to <0.70 for men and >= 1.07 to <0.62 for women) were 0.89 (95% CI: 0.65, 1.22), 1.08 (95% CI: 0.85, 1.36), and 1.28 (95% CI: 1.02, 1.61) in normal-weight, overweight, and obese participants, respectively. The highest quintile of dietary sodium was associated with an increased OR for albuminuria in obese participants (OR: 1.44; 95% CI: 1.00, 2.07) but not in normal-weight or overweight participants. Dietary potassium was not associated with albuminuria. Conclusion: In obese adults, higher dietary Na/K and sodium intakes were associated with albuminuria. Am J Clin Nutr 2011;94:1071-8.