Analysis of the Association between Sodium Intake and Albuminuria in Diabetic Patients without Chronic Kidney Disease: A Cross-Sectional Study Based on the 8th Korea National Health and Nutrition Examination Survey (2019–2021)

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Background: Evidence that sodium restriction reduces the risk of albuminuria in diabetic patients without chronic kidney disease (CKD) remains insufficient.In this study, using data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES), we aimed to investigate the association between sodium restriction and albuminuria in diabetic patients without CKD.Methods: We analyzed 2,253 diabetic patients aged 19 years or older without CKD from the 8th KNHANES (2019KNHANES ( -2021)).Sodium intake was estimated using the Kawasaki formula from spot urine samples and divided into quartiles for analysis (1Q, first quartile; 2Q, second quartile; 3Q, third quartile; 4Q, fourth quartile).Albuminuria was classified as normal (<30 mg/g), microalbuminuria (30 to <300 mg/g), and macroalbuminuria (≥300 mg/g) based on the urine albumin-to-creatinine ratio.To determine the association between quartiles of estimated daily sodium intake and albuminuria, multinomial logistic regression analysis was performed, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.Results: Compared with the 1Q group, the OR in the 4Q group was 1.42 (95% CI, 1.04-1.95;P=0.029) for microalbuminuria and 3.29 (95% CI, 1.46-7.40;P=0.004) for macroalbuminuria after adjusting for all covariates.In all models, the ORs of the 2Q and 3Q groups compared with the 1Q group did not differ significantly between the micro-and macroalbuminuria groups.Conclusion: Compared with the 1Q group, we observed a significant increase in the OR of albuminuria in the 4Q group, indicating a potential association between high sodium intake and albuminuria, even in diabetic patients without CKD.