Mean population salt intake estimated from 24-h urine samples and spot urine samples: a systematic review and meta-analysis.

BACKGROUND Estimating equations based on spot urine samples have been identified as a possible alternative approach to 24-h urine collections for determining mean population salt intake. This review compares estimates of mean population salt intake based upon spot and 24-h urine samples. METHODS We systematically searched for all studies that reported estimates of daily salt intake based upon both spot and 24-h urine samples for the same population. The associations between the two were quantified and compared overall and in subsets of studies. RESULTS A total of 538 records were identified, 108 were assessed as full text and 29 were included. The included studies involved 10,414 participants from 34 countries and made 71 comparisons available for the primary analysis. Overall average population salt intake estimated from 24-h urine samples was 9.3 g/day compared with 9.0 g/day estimated from the spot urine samples. Estimates based upon spot urine samples had excellent sensitivity (97%) and specificity (100%) at classifying mean population salt intake as above or below the World Health Organization maximum target of 5 g/day. Compared with the 24-h samples, estimates based upon spot urine overestimated intake at lower levels of consumption and underestimated intake at higher levels of consumption. CONCLUSIONS Estimates of mean population salt intake based upon spot urine samples can provide countries with a good indication of mean population salt intake and whether action on salt consumption is required.

[1]  N. Sun,et al.  Validation of the Spot Urine in Evaluating 24-Hour Sodium Excretion in Chinese Hypertension Patients. , 2015, American journal of hypertension.

[2]  C. Anderson,et al.  Developing a national salt reduction strategy for Mongolia. , 2015, Cardiovascular diagnosis and therapy.

[3]  T. Jørgensen,et al.  Estimating salt intake in a Caucasian population: can spot urine substitute 24-hour urine samples? , 2014, European journal of preventive cardiology.

[4]  Majid Ezzati,et al.  Global sodium consumption and death from cardiovascular causes. , 2014, The New England journal of medicine.

[5]  S. Yusuf,et al.  Urinary sodium and potassium excretion, mortality, and cardiovascular events. , 2014, The New England journal of medicine.

[6]  K. Sung,et al.  Estimation of 24-Hour Urinary Sodium Excretion Using Spot Urine Samples , 2014, Nutrients.

[7]  S. Yusuf,et al.  Validation and comparison of three formulae to estimate sodium and potassium excretion from a single morning fasting urine compared to 24-h measures in 11 countries , 2014, Journal of hypertension.

[8]  Toshikazu Shiga,et al.  Six random specimens of daytime casual urine on different days are sufficient to estimate daily sodium/potassium ratio in comparison to 7-day 24-h urine collections , 2014, Hypertension Research.

[9]  R. McLean,et al.  Monitoring population sodium intake using spot urine samples: validation in a New Zealand population , 2014, Journal of Human Hypertension.

[10]  F. Cappuccio,et al.  Comparisons of spot vs 24-h urine samples for estimating population salt intake: validation study in two independent samples of adults in Britain and Italy. , 2014, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[11]  A. Husseini,et al.  Salt reduction as a population-based intervention for the prevention of coronary heart diseases: an economic assessment , 2013, The Lancet.

[12]  Peilin Shi,et al.  Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide , 2013, BMJ Open.

[13]  P. Elliott,et al.  Validity of predictive equations for 24-h urinary sodium excretion in adults aged 18-39 y. , 2013, The American journal of clinical nutrition.

[14]  S. Sethi,et al.  Spot urine tests in predicting 24-hour urine sodium excretion in Asian patients. , 2013, Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation.

[15]  Jin-Hong Shin,et al.  Genetics of Mitochondrial Myopathies , 2013 .

[16]  Ian J. Brown,et al.  Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations: the INTERSALT study. , 2013, American journal of epidemiology.

[17]  M. Zimmermann,et al.  Assessment of iodine nutrition in populations: past, present, and future. , 2012, Nutrition reviews.

[18]  J. Mill,et al.  Correlation between sodium and potassium excretion in 24- and 12-h urine samples , 2012, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[19]  Amitava Banerjee,et al.  Tracking global funding for the prevention and control of noncommunicable diseases. , 2012, Bulletin of the World Health Organization.

[20]  Soon Bae Kim,et al.  Use of mean spot urine sodium concentrations to estimate daily sodium intake in patients with chronic kidney disease. , 2012, Nutrition.

[21]  Lee Hooper,et al.  Guideline: Potassium intake for adults and children , 2012 .

[22]  M. Hayashi,et al.  Validation of the equations for estimating daily sodium excretion from spot urine in patients with chronic kidney disease , 2011, Clinical and Experimental Nephrology.

[23]  B. Blount,et al.  Estimating perchlorate exposure from food and tap water based on US biomonitoring and occurrence data , 2011, Journal of Exposure Science and Environmental Epidemiology.

[24]  S. McGuire.  Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. , 2010, Advances in nutrition.

[25]  L. Gerber,et al.  Estimation of 24‐Hour Sodium Excretion from Spot Urine Samples , 2010, Journal of clinical hypertension.

[26]  Christine L. Taylor,et al.  Strategies to Reduce Sodium Intake in the United States , 2010 .

[27]  K. Kostial,et al.  Comparison of calcium, magnesium, sodium, potassium, zinc, and creatinine concentration in 24-h and spot urine samples in women , 2009, Clinical chemistry and laboratory medicine.

[28]  A. Kodali,et al.  Creatinine corrections for estimating children's and adult's pesticide intake doses in equilibrium with urinary pesticide and creatinine concentrations , 2008, Journal of Exposure Science and Environmental Epidemiology.

[29]  Anne Gabriel,et al.  Nighttime Blood Pressure and Nocturnal Dipping Are Associated With Daytime Urinary Sodium Excretion in African Subjects , 2008, Hypertension.

[30]  Xu Ze,et al.  Experimental and clinical experiences with peritoneo-venous shunt (locally made Z-CI device) in the treatment of intractable ascites , 2008, Acta Academiae Medicinae Wuhan.

[31]  Julian P T Higgins,et al.  Controlling the risk of spurious findings from meta‐regression , 2004, Statistics in medicine.

[32]  A. A. Rosa,et al.  Estimation of sodium intake by urinary excretion and dietary records in children and adolescents from Porto Alegre, Brazil: a comparision of two methods , 2003 .

[33]  O. Tochikubo,et al.  Estimation of 24-h urinary sodium excretion using lean body mass and overnight urine collected by a pipe-sampling method , 2002, Journal of hypertension.

[34]  H. Ueshima,et al.  A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen , 2002, Journal of Human Hypertension.

[35]  A. Dyer,et al.  Blood pressure and diurnal variation in sodium, potassium, and water excretion , 1998, Journal of Human Hypertension.

[36]  W. Pan,et al.  Diurnal electrolyte excretion pattern affects estimates of electrolyte status based on 24-hour, half-day, and overnight urine. , 1994, The Chinese journal of physiology.

[37]  P. Whelton,et al.  Agreement between overnight and 24-hour urinary cation excretions in southern Chinese men. , 1993, American journal of epidemiology.

[38]  K. Itoh,et al.  A SIMPLE METHOD FOR ESTIMATING 24 H URINARY SODIUM AND POTASSIUM EXCRETION FROM SECOND MORNING VOIDING URINE SPECIMEN IN ADULTS , 1993, Clinical and experimental pharmacology & physiology.

[39]  J. Cutler,et al.  Variance imputation for overviews of clinical trials with continuous response. , 1992, Journal of clinical epidemiology.

[40]  F. Simpson.  SODIUM INTAKE, BODY SODIUM, AND SODIUM EXCRETION , 1988, The Lancet.

[41]  A. Dyer,et al.  Do hypertensive patients have a different diurnal pattern of electrolyte excretion? , 1987, Hypertension.

[42]  L. Liu,et al.  Variability of urinary sodium and potassium excretion in north Chinese men. , 1987, Journal of hypertension.

[43]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[44]  L. Liu,et al.  Variability in 24-hour urine sodium excretion in Chinese adults. , 1986, Chinese medical journal.

[45]  M. Henriet,et al.  Expression of plasma renin activity in terms of urinary sodium excretion and posture in normal subjects on free sodium intake. , 1984, Renal physiology.

[46]  J. Stamler,et al.  Assessment of sodium intake in epidemiological studies on blood pressure. , 1984, Annals of clinical research.

[47]  N. Fineberg,et al.  The utility of overnight urine collections in assessing compliance with a low sodium intake diet. , 1983, JAMA.

[48]  R. Sloan,et al.  Estimating Dietary Sodium Intake in Individuals Receiving a Randomly Fluctuating Intake , 1982, Hypertension.

[49]  N. Fineberg,et al.  Overnight Urine Collections to Estimate Sodium Intake , 1982, Hypertension.

[50]  J. Stamler,et al.  Assessment of the association between habitual salt intake and high blood pressure: methodological problems. , 1979, American journal of epidemiology.

[51]  C. M. Chen,et al.  Plasma renin activity and sodium excretion in normal and hypertensive Chinese. , 1975, Taiwan yi xue hui za zhi. Journal of the Formosan Medical Association.

[52]  M. Buchsbaum,et al.  Diurnal variation in serum and urine electrolytes. , 1971, Journal of applied physiology.

[53]  S. Stanbury,et al.  Diurnal variation in electrolyte excretion. , 1951, Clinical science.