Evidence mapPaperPMID 40748558Full record

ArticleClinical rheumatology2025

Sodium, potassium intake and urinary sodium-to-potassium ratio in rheumatoid arthritis: association with markers of cardiovascular dysfunction and disease-related parameters.

Panagiota Anyfanti, Christina Antza, Alexandra Ainatzoglou, Elena Angeloudi, Smaro Palaska, Dimitrios Poulis, Evangelia Chaida, Theodoros Dimitroulas, Vasilios Kotsis, Eugenia Gkaliagkousi

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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Panagiota Anyfanti3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. panyfan@hotmail.com.ORCID http://orcid.org/0000-0002-5658-4629
Christina Antza3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Alexandra AinatzoglouFourth Department of Internal Medicine, Hippokration Hospital, Thessaloniki, Greece.
Elena AngeloudiSecond Medical Department, Hippokration Hospital, Thessaloniki, Greece.
Smaro Palaska3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dimitrios Poulis3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Evangelia Chaida3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Theodoros DimitroulasFourth Department of Internal Medicine, Hippokration Hospital, Thessaloniki, Greece.
Vasilios Kotsis3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Eugenia Gkaliagkousi3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

objectivesPatients with rheumatoid arthritis (RA) are at increased cardiovascular risk. Rather than either sodium or potassium intake alone, the ratio of urinary sodium-to-potassium excretion has been introduced as a simple and useful indicator of diet quality and a more reliable index of cardiovascular risk assessment. We assessed the clinical impact of sodium-to-potassium ratio as a marker of cardiovascular health in patients with RA.

methodSodium and potassium intake were assessed from 24-h urine samples, and urinary sodium-to-potassium ratio was calculated in patients with RA. Myocardial perfusion was assessed by measurement of subendocardial viability ratio (SEVR) using applanation tonometry. Pulse wave velocity and augmentation index were assessed as markers of arterial stiffness with the same device.

resultsAmong 61 patients with RA, only two presented an optimal sodium-to-potassium ratio of ≤ 1. In univariate analysis, urinary sodium excretion was significantly associated with high-density lipoprotein cholesterol (HDL-c) and uric acid. Potassium excretion positively correlated with estimated glomerular filtration rate (eGFR) and negatively with disease activity and inflammatory load. No associations were observed between markers of arterial stiffness and either urinary sodium excretion, potassium excretion, or their ratio. By contrast, both urinary sodium and urinary sodium-to-potassium ratio inversely correlated with SEVR, and these associations remained significant even after adjustment for other variables (beta =  - 0.247, p = 0.034, and beta =  - 0.247, p = 0.026, respectively).

conclusionsFindings from the present study suggest that in concordance with population-based studies, urinary sodium-to-potassium ratio might serve as an indicator of myocardial health in patients with autoimmune inflammatory diseases such as RA. Key Points • Increased dietary sodium intake, decreased dietary potassium intake, and increased sodium-to-potassium ratio have been associated with adverse cardiovascular outcomes in longitudinal population-based cohorts. • In a population of high cardiovascular risk patients with RA, increased dietary sodium intake and increased urinary sodium-to-potassium ratio were both associated with impaired coronary microvascular perfusion. • Dietary potassium intake inversely correlated with disease activity and inflammatory load. • In patients with chronic inflammatory arthritis, interventions aiming at dietary modifications of sodium and potassium intake might positively affect both cardiovascular outcomes and disease-related parameters.

Indexed as

Arthritis, RheumatoidCardiovascular DiseasesPotassiumPotassium, DietarySodiumSodium, DietaryAdultAgedBiomarkersCholesterol, HDLFemaleGlomerular Filtration RateHumansMaleMiddle AgedPulse Wave AnalysisBiomarkersCholesterol, HDLPotassiumPotassium, DietarySodiumSodium, DietaryArterial stiffnessMyocardial perfusionPotassium intakeRheumatoid arthritisSodium intakeUrinary sodium-to-potassium ratio

Identifiers

PMID40748558
PMCPMC12397137

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.