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Trends in Daily Dietary Sodium Intake Among Adults with CKD

Trends in Daily Dietary Sodium Intake Among Adults with CKD

According to the Dietary Guidelines for Americans 2020–2025, U.S. adults should consume less than 2,300 mg of sodium per day. During 2005–March 2020, the prevalence of adults adhering to these guidelines was higher among those with CKD than without CKD. Women with CKD or those aged ≥70 years were more likely to adhere to these guidelines compared to their counterparts.

Data Source: NHANES

To view the trends in adherence to the recommended daily sodium intake by risk categories, select from the drop-down menu below. Risk categories include CKD, Age Category, Sex, Race/Ethnicity, Diabetes, and Hypertension.


Adults with Sodium Intake <2,300 mg/day (%), by CKD

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Data includes CKD stages 1–5. Estimates were standardized to the 2010 U.S. Census population for adults.

NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center. Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.

Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.

FieldData
Description of Measure

Time trends in prevalence of adults with CKD within recommended daily sodium intake guidelines.

Data Set

National Health and Nutrition Examination Survey (NHANES).

Population

Noninstitutionalized US adults aged ≥ 18 years, pregnant women excluded.

Years Included

2005–March 2020.

Numerator

U.S. adults aged ≥ 18 years with CKD who are meeting the recommended sodium intake recommendation.

Denominator

U.S. adults aged ≥ 18 years with CKD who had daily sodium intake measurements, overall or by each defined stratum.

Definition of CKD

CKD is defined by an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Estimates are based on single estimates of eGFR and UACR.

Estimated Glomerular Filtration Rate (eGFR)

Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20 x 0.9938**age x (1.012 if female).

κ = 0.7 if female and 0.9 if male
α = -0.241 if female and -0.302 if male
** = raise to the power

Albuminuria

UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.

Serum Creatinine

Serum creatinine values used for eGFR calculation are standardized against isotope dilution mass spectrometry (IDMS).

Urine Albumin

Measured in random urine collection by fluorescent immunoassay.

Diabetes

Diabetes is defined by self-report of diabetes, treatment with insulin or oral anti-diabetes medications, or HbA1c ≥ 6.5%.

Hypertension

Hypertension is defined by self-reported hypertension, treatment with hypertension medications, or average systolic blood pressure greater than 140 mmHg (130 mmHg for CKD and diabetes) and diastolic blood pressure greater than 90 mmHg (80 mmHg for CKD and diabetes).

Sodium Intake

Self-reported sodium (mg) was derived from the NHANES one day dietary questionnaire.

Adherence to Sodium Consumption Guidelines

Sodium intake is defined by consuming less than 2,300 mg per day, as defined by the Dietary Guidelines for Americans 2020–2025.

Age Standardization

Estimates were standardized to the 2010 U.S. Census population for adults: 18–39 years: 37.1%, 40–59 years: 38.1%, 60–69 years: 12.8%, and 70+ years: 12.0%. 

Limitations of Indicator

Albuminuria and kidney function are assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence. Self-reported sodium intake may be subject to recall bias.    

Analytical Considerations

Appropriate NHANES survey weights are used for all analyses; if the relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.


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