[The impact of dietary sodium intake on therapeutic efficacy and short-term renal injury in patients after treatment for primary aldosteronism].

Authors

Q R Deng, Y Du, Z T Zhong, Z X Chen, Y W Yang, L Zhang, Y Guo, S L Zhang

Published in

Zhonghua yi xue za zhi. Volume 106. Issue 27. Pages 2834-2841. Jul 28, 2026.

Abstract

Objective: To evaluate the impact of dietary sodium intake on therapeutic efficacy and short-term renal injury in patients after treatment for primary aldosteronism(PA). Methods: A retrospective study was conducted on PA patients admitted between May 2017 and November 2024. Sodium intake was assessed via 24 h urinary sodium excretion before treatment. Patients were categorized into normal sodium (<6 g/d) and moderate-to-high sodium (≥6 g/d) groups. The baseline clinical characteristics of the two groups were compared. Spearman correlation analysis was used to analyze the correlations between sodium intake and baseline clinical indicators. The efficacy and renal function indicators were compared after 6 months of mineralocorticoid receptor antagonist (MRA) therapy or adrenalectomy. Restricted cubic spline model were used to analyze the nonlinear correlations between sodium intake and post-treatment urinary albumin-to-creatinine ratio (UACR). Results: A total of 239 patients were enrolled, including 122 males and 117 females with the age of (49.0±11.3) years. Among them, 72 patients were categorized into the normal sodium intake group and 167 into the moderate-to-high sodium intake group. Levels of UACR, urinary albumin excretion rate (UAER), 24 h urinary protein and 24 h urinary potassium were significantly higher in the moderate-to-high sodium intake group relative to the normal sodium intake group (all P<0.05). Spearman correlation analysis demonstrated that daily sodium intake was positively correlated with systolic blood pressure (SBP) (r=0.180), 24 h urinary potassium (r=0.375), UACR (r=0.224) and UAER (r=0.150) in patients with primary aldosteronism (all P<0.05). Following MRA pharmacotherapy, patients in the moderate-to-high sodium intake group exhibited higher SBP [130.0(120.0, 140.0) vs 120.0(119.0, 130.0) mmHg(1 mmHg=0.133 kPa), P=0.026] and a lower proportion of normotensive cases [65.6%(40/61) vs 90.9%(30/33), P=0.010] compared with the normal sodium intake group. After surgical intervention, the moderate-to-high sodium intake group achieved a greater reduction in SBP [-17.3(-26.5, -9.5) vs -7.0(-24.7, 1.7) mmHg, P=0.023], alongside a more prominent decline in UACR [-11.15(-35.75, 4.75) vs 0.10(-7.28, 7.33) mg/g, P=0.008] than the normal sodium intake group. Restricted cubic spline analysis revealed a "J-shaped" nonlinear association between baseline sodium intake and postoperative UACR. When sodium intake was ≥6.65 g/d, postoperative UACR increased progressively along with rising sodium intake. Conclusions: Moderate-to-high sodium intake is detrimental to blood pressure control and renal protection in patients with PA, while surgical treatment can partially alleviate the negative effects of moderate-to-high sodium intake on their blood pressure and kidneys. Sodium intake restriction should be an important component of comprehensive management for PA.

PMID:
42503920
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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