Sodium and potassium intake as determinants of cardiovascular and renal health

Worldwide, there is an increase in the prevalence of cardiovascular disease and chronic kidney disease. Intake of dietary minerals, in particular sodium and potassium, might play an important role in the prevention of these chronic diseases. However, the evidence on the potential beneficial effects of these dietary interventions is inconsistent.The discrepancies in literature might partly be explained by methodological issues of studies, including varying – and often inaccurate– methods used for the assessment of dietary sodium and potassium intake, including dietary questionnaires. In the studies included in this thesis, the intake of sodium and potassium was determined by measuring the excretion in 24-hour urine collections, which is considered the most accurate characterization of an individual’s mean sodium and potassium intake.Results of thesis suggest that a low sodium intake is associated with an increased risk of stroke in the general population. Despite the effect of sodium on blood pressure, we could not identify an association between sodium intake and risk of developing chronic kidney disease.Furthermore, the results suggest an important role of sufficient potassium intake in the prevention of a high blood pressure and chronic kidney disease in a population-based cohort, and also with poor long-term outcome in renal transplant recipients, including renal graft failure and all-cause mortality. Despite these findings, we could not identify an association between potassium intake and risk of cardiovascular disease