Urinary Sodium and Potassium Excretion in Bangladeshi Adults: Results from a Population-Based Survey with 24-Hour Urine Collections

Jubaida Akhtar; Mohammad A. Al-Mamun; Mohammad N.-N. Sayem; Mohammad J. Ahmed; Mahfuzur R. Bhuiyan; Shamim Jubayer; Mohammad R. Amin; Md. R. Karim; Megan E. Henry; Matti Marklund; Laura Cobb; Dinesh Neupane; Lawrence J. Appel; Sohel R. Choudhury

doi:10.5334/gh.1447

Urinary Sodium and Potassium Excretion in Bangladeshi Adults: Results from a Population-Based Survey with 24-Hour Urine Collections

Volume 20 (2025): Issue 1

By: Jubaida Akhtar , Mohammad A. Al-Mamun , Mohammad N.-N. Sayem , Mohammad J. Ahmed, Mahfuzur R. Bhuiyan , Shamim Jubayer , Mohammad R. Amin , Md. R. Karim, Megan E. Henry , Matti Marklund, Laura Cobb, Dinesh Neupane , Lawrence J. Appel and Sohel R. Choudhury

Open Access

|Jul 2025

Figures & Tables

Table 1

Baseline characteristics of urinary sodium and potassium excretion of the study participants (both excluded and included), Bangladesh, December 2017 and June 2018.

VARIABLES	INCLUDED (N = 509)	EXCLUDED (N = 330)	P VALUE
Age (years)	43.0 ± 7.9	44.0 ± 8.3	0.083
Female	259 (50.9)	159 (48.2)	0.444
Urban	259 (50.9)	161 (48.8)	0.553
BMI (kg/m²)	23.9 ± 4.2	24.5 ± 4.7	0.059
Systolic BP (mmHg)	118.6 ± 16.6	121.8 ± 19.0	0.010
Diastolic BP (mmHg)	76.3 ± 11.3	78.3 ± 12.1	0.013
Hypertension, yes	105 (20.6)	110 (33.3)	<0.001
Diabetes, yes	32 (6.3)	24 (7.3)	0.563
Level of education			0.033
No education	58 (11.4)	62 (18.8)
Primary level	218 (42.8)	119 (36.2)
Secondary level	142 (27.9)	95 (28.9)
Higher secondary level	40 (7.9)	22 (6.7)
Graduation and above	51 (10.0)	31 (9.4)
Add salt during meal			0.188
Never	227 (44.6)	147 (44.6)
Rarely	33 (6.5)	36 (10.9)
Sometimes	136 (26.7)	78 (23.6)
Often	35 (6.9)	18 (5.5)
Always	78 (15.3)	51 (15.5)
Amount of extra salt added during meal (n = 465)			0.509
One pinch	229 (81.2)	153 (83.6)
More than one pinch	53 (18.8)	30 (16.4)
Daily smoker	109 (21.4)	67 (20.3)	0.699
Daily smokeless tobacco user	158 (31.0)	102 (30.9)	0.968

[i] N = Number of observations; SD = Standard Deviation; n = Frequency; BP: Blood pressure; BMI: Body Mass Index.

Note: A meal refers to consuming a substantial amount of food at regular intervals throughout the day, such as breakfast, lunch, or supper.

Violin plot of distributions of urinary (dietary) sodium by gender and place of residence of the study participants, Bangladesh, December 2017 and June 2018 (N = 509). The horizontal line at 2 g/d indicates the upper limit of intake recommended by WHO.

Violin plot of distributions of potassium intake by gender and place of residence of the study participants. The horizontal line at 3.5 g/d indicates the lower limit of intake recommended by WHO.

Table 2

Differences in urinary (dietary) sodium, urinary potassium, and dietary potassium by risk factors among the study participants, Bangladesh, December 2017 and June 2018 (N = 509).

VARIABLES	n (%)	URINARY SODIUM (g/DAY)		URINARY POTASSIUM (g/DAY)		DIETARY POTASSIUM (g/DAY)
VARIABLES	n (%)	MEAN (95% CI)	*ADJUSTED MEAN (95%CI)	MEAN (95% CI)	*ADJUSTED MEAN (95% CI)	MEAN (95% CI)	*ADJUSTED MEAN (95% CI)
Age (year)
30–39	187 (36.7)	3.8 (3.6–4.0)	3.8 (3.6–4.0)	1.3 (1.3–1.4)	1.4 (1.3–1.4)	1.9 (1.8–2.0)	1.9 (1.8–2.0)
40–49	208 (40.9)	4.0 (3.8–4.2)	4.0 (3.8–4.2)	1.4 (1.4–1.5)	1.4 (1.4–1.5)	2.0 (1.9–2.1)	2.0 (1.9–2.1)
50–59	114 (22.4)	3.8 (3.5–4.1)	3.8 (3.5–4.1)	1.3 (1.2–1.4)	1.3 (1.2–1.4)	1.9 (1.8–2.0)	1.9 (1.8–2.0)
Gender
Female	259 (50.9)	3.8 (3.6–3.9)	3.8 (3.6–3.9)	1.3 (1.3–1.4)	1.3 (1.3–1.4)	1.9 (1.8–2.0)	1.9 (1.8–2.0)
Male	250 (49.1)	4.0 (3.8–4.2)	4.0 (3.8–4.2)	1.4 (1.4–1.5)	1.4 (1.4–1.5)	2.0 (1.9–2.0)	2.0 (1.9–2.1)
Place of residence
Urban	259 (50.9)	4.1 (3.9–4.2)	4.0 (3.9–4.2)	1.4 (1.4–1.5)	1.4 (1.4–1.5)	2.0 (2.0–2.1)	2.0 (2.0–2.1)
Rural	250 (49.1)	3.7 (3.5–3.9)	3.7 (3.5–3.9)	1.3 (1.3–1.4)	1.3 (1.3–1.4)	1.9 (1.8–2.0)	1.9 (1.8–2.0)
Add salt before eating
Never	227 (44.6)	3.8 (3.6–4.0)	3.8 (3.6–4.0)	1.4 (1.4–1.5)	1.4 (1.3–1.4)	2.0 (1.9–2.1)	2.0 (1.9–2.1)
Rarely/Sometimes/Often	204 (40.1)	3.9 (3.7–4.1)	3.9 (3.7–4.1)	1.4 (1.3–1.5)	1.4 (1.4–1.5)	2.0 (1.9–2.1)	2.0 (1.9–2.1)
Always	78 (15.3)	4.1 (3.7–4.5)	4.1 (3.8–4.4)	1.3 (1.1–1.4)	1.3 (1.1–1.4)	1.8 (1.6–1.9)	1.8 (1.6–1.9)
How much salt do you think you consume?
Right amount	414 (81.3)	3.9 (3.7–4.0)	3.9 (3.7–4.0)	1.4 (1.3–1.4)	1.4 (1.3–1.4)	2.0 (1.9–2.0)	2.0 (1.9–2.0)
Low	45 (8.8)	3.8 (3.4–4.2)	3.8 (3.3–4.2)	1.4 (1.3–1.5)	1.4 (1.2–1.5)	2.0 (1.8–2.2)	2.0 (1.8–2.2)
High	50 (9.8)	4.2 (3.6–4.7)	4.2 (3.8–4.6)	1.4 (1.3–1.6)	1.4 (1.3–1.6)	2.0 (1.8–2.2)	2.0 (1.8–2.2)
High salt diet causes a serious health problem
Yes	263 (51.7)	4.0 (3.8–4.2)	4.0 (3.8–4.2)	1.4 (1.4–1.5)	1.4 (1.4–1.5)	2.0 (2.0–2.1)	2.0 (2.0–2.1)
No	44 (8.6)	3.8 (3.4–4.3)	3.8 (3.4–4.3)	1.4 (1.3–1.6)	1.4 (1.3–1.5)	2.0 (1.8–2.2)	2.0 (1.8–2.2)
Don’t know	202 (39.7)	3.8 (3.6–4.0)	3.8 (3.6–4.0)	1.3 (1.2–1.4)	1.3 (1.2–1.4)	1.8 (1.8–1.9)	1.8 (1.8–1.9)
Importance of salt reduction in food
Very important	203 (39.9)	4.0 (3.8–4.2)	4.0 (3.8–4.2)	1.4 (1.4–1.5)	1.4 (1.4–1.5)	2.1 (2.0–2.2)	2.1 (2.0–2.2)
Somehow important	256 (50.3)	3.9 (3.7–4.0)	3.9 (3.7–4.0)	1.3 (1.3–1.4)	1.3 (1.3–1.4)	1.9 (1.8–2.0)	1.9 (1.8–2.0)
Not important/Do not know	50 (9.8)	3.7 (3.2–4.1)	3.7 (3.2–4.1)	1.4 (1.2–1.5)	1.4 (1.3–1.5)	2.0 (1.8–2.2)	2.0 (1.8–2.2)

[i] *Gender-adjusted for age, age-adjusted for gender, age and gender-adjusted for other variables; n = Frequency; CI = Confidence Interval.

Table 3

Multivariable regression analyses*, associating blood pressure with urinary sodium (Na), potassium (K), and urinary sodium/potassium (Na/K) ratio (n = 509).

	SYSTOLIC BP (mmHg)			DIASTOLIC BP (mmHg)
	β	95% CI OF β	P VALUE	β	95% CI OF β	P VALUE
Na (g/day)	0.91	–0.04–1.85	0.06	0.82	0.17–1.47	0.014
K (g/day)	0.39	–2.53–3.32	0.80	1.32	–0.69–3.33	0.20
Na/K ratio (mmol/L)	0.15	0.54–0.83	0.68	0.12	0.35–0.58	0.63

[i] *Separate analysis for systolic and diastolic BP, and separate for Na, K and Na/K ratio. Each model was adjusted for age and sex.

Table 4

Logistic regression* for predicting hypertension with urinary sodium (Na), potassium (K), and urinary sodium/potassium (Na/K) ratio (n = 509).

	ODDS RATIO	95% CI OF ODDS RATIO	P VALUE
Na (gm/day)	1.08	0.94–1.25	0.285
K (gm/day)	1.02	0.74–1.41	0.910
Na/K ratio (mmol/L)	1.05	0.94–1.17	0.410

[i] *Separate analysis for Na, K and Na/K. Each model was adjusted for age and sex.

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DOI: https://doi.org/10.5334/gh.1447 | Journal eISSN: 2211-8179

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Language: English

Submitted on: Feb 18, 2025

Accepted on: Jun 23, 2025

Published on: Jul 14, 2025

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Sodium,

© 2025 Jubaida Akhtar, Mohammad A. Al-Mamun, Mohammad N.-N. Sayem, Mohammad J. Ahmed, Mahfuzur R. Bhuiyan, Shamim Jubayer, Mohammad R. Amin, Md. R. Karim, Megan E. Henry, Matti Marklund, Laura Cobb, Dinesh Neupane, Lawrence J. Appel, Sohel R. Choudhury, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 20 (2025): Issue 1

Urinary Sodium and Potassium Excretion in Bangladeshi Adults: Results from a Population-Based Survey with 24-Hour Urine Collections

Figures & Tables

Table 1

Figure 1

Figure 2

Table 2

Table 3

Table 4

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