Is urinary Na/K ratio an independent indicator associated with current hypertension and RA disease activity or just an artifact? Comment on article by Minamino H et al

@article{Rastmanesh2021IsUN,
  title={Is urinary Na/K ratio an independent indicator associated with current hypertension and RA disease activity or just an artifact? Comment on article by Minamino H et al},
  author={Reza Rastmanesh},
  journal={Arthritis Research \& Therapy},
  year={2021},
  volume={23}
}
  • R. Rastmanesh
  • Published 8 July 2021
  • Medicine
  • Arthritis Research & Therapy
I read with interest the article by Minamino et al. [1]. I would like to clarify some of the significant findings and suggest re-analysis needed to validate their core conclusion. Authors have concluded that urinary Na/K ratio is an independent indicator associated with current RA disease activity. First, physiologically, with regard to dietary sodium intake, it is worth to remind that some people are more sodium-responsive [2]. In a recent study in Japanese evacuees after the Great East Japan… 
1 Citations
Comment on “Urinary sodium-to-potassium ratio associates with hypertension and current disease activity in patients with rheumatoid arthritis: a cross-sectional study”: authors’ reply
TLDR
This study aimed to determine whether dietary intake of sodium and potassium could affect the incidence of hypertension and disease activity in RA patients and cited two papers, one stating that the RAA system influenced RA disease activity, and the other stating that renin was differentially expressed in RA and osteoarthritis.

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Urinary sodium-to-potassium ratio associates with hypertension and current disease activity in patients with rheumatoid arthritis: a cross-sectional study
TLDR
Urinary Na/K ratio was independently associated with current disease activity as well as with prevalence of hypertension in RA patients and dietary modifications such as salt restriction and potassium supplementation should be investigated as a potential candidate for attenuating both disease activity and hypertension inRA patients.
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TLDR
The adverse association of dietary sodium with BP is minimally attenuated by other dietary constituents; these findings underscore the importance of reducing salt intake for the prevention and control of prehypertension and hypertension.
Urinary potassium is as reliable as urinary nitrogen for use as a recovery biomarker in dietary studies of free living individuals.
TLDR
The high correlations between UK and K in the diet show that UK is a reliable recovery biomarkers for use in studies of dietary measurement error and factors for use of urinary N as a recovery biomarker are confirmed.
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TLDR
Advice to increase the intake of vegetables and fruits, fish, and milk may be useful to increase potassium intake in Japan.
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TLDR
Findings suggest that ouabainlike compound with biological activity could partly account for hypertension in ectopic corticotropin syndrome.
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TLDR
Urinary creatinine, total caloric intake, and percentages of nutrient intake from mixed dishes were independently and consistently associated with the differences between diet and urine estimates of sodium and potassium intake.
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TLDR
These results indicate that potassium reduces the rise in blood pressure caused by sodium chloride and reduces the increased sympathetic postural response seen in people on a low sodium intake.
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TLDR
Novel insights on NCC regulation are embedded into existing concepts of K+ homeostasis in health and disease, as epidemiological data reveal associations between higher urinary K+ excretion and improved renal outcomes.
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TLDR
Tissue-specific regulation of renin expression is demonstrated and imply different functions for the sodium responsive and nonresponsive systems.
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