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Increased sodium, decreased potassium intake and their ratio have been acknowledged as CVD risk modifiers, while pathophysiological studies suggest a role in autoimmunity and inflammation. We aimed to review in a systematic manner the literature regarding the effects of dietary sodium, potassium intake and their ratio, on cardiovascular and disease-related outcomes in patients with RA. We performed a systematic literature search in Medline and Cochrane. Our research concluded to 1,283 patients (8 studies). Although not all studies coincide, most agree that increased dietary sodium and reduced dietary potassium intake are adversely associated with disease related (rheumatic and immunologic) outcomes. The ratio between sodium and potassium emerges a potential indicator of autoimmunity state that needs to be further balanced. Only 4 studies reported associations with cardiovascular outcomes in RA, particularly hypertension, although not consistently and none with hard CVD endpoints. These findings support that interventions promoting a poor in sodium and rich in potassium diet in RA may have beneficial effects in terms of autoimmunity regulation, suppression of inflammation and improvement in cardiovascular health.<\/jats:p>","DOI":"10.1007\/s00296-026-06104-5","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T01:31:24Z","timestamp":1775007084000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sodium and potassium intake in rheumatoid arthritis: a systematic review of clinical studies with implications for disease-related outcomes"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5658-4629","authenticated-orcid":false,"given":"Panagiota","family":"Anyfanti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5164-7435","authenticated-orcid":false,"given":"Christina","family":"Antza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5764-1320","authenticated-orcid":false,"given":"Konstantinos","family":"Tragiannidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7848-6600","authenticated-orcid":false,"given":"Andrej","family":"Belan\u010di\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-5133","authenticated-orcid":false,"given":"Yusuf Ziya","family":"\u015eener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9039-0197","authenticated-orcid":false,"given":"Andrea Katrin","family":"Faour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4502-5290","authenticated-orcid":false,"given":"Alexandra","family":"Ainatzoglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3492-7915","authenticated-orcid":false,"given":"Elena","family":"Angeloudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6854-3669","authenticated-orcid":false,"given":"Evangelia","family":"Chaida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0364-1642","authenticated-orcid":false,"given":"Theodoros","family":"Dimitroulas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3755-8097","authenticated-orcid":false,"given":"Vasilios","family":"Kotsis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"6104_CR1","doi-asserted-by":"publisher","first-page":"284","DOI":"10.31138\/mjr.20230801.oo","volume":"34","author":"M Jahid","year":"2023","unstructured":"Jahid M, Khan KU, Rehan-Ul-Haq, Ahmed RS (2023) Overview of Rheumatoid Arthritis and Scientific Understanding of the Disease. 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TD has also received non-financial support for meeting attendance from AbbVie, Genesis Pharma, Janssen, Elpen, Enorasis, UCB, and Pfizer.All other authors declare no competing interests related to this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study is a systematic review of previously published studies. Ethical approval was not required, as no new data were collected and no human participants or animals were directly involved.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent is not applicable; the study is based exclusively on the analysis of data from published studies.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"69"}}