{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:47:58Z","timestamp":1782841678092,"version":"3.54.5"},"reference-count":30,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"\n Background<\/jats:title>\n While excessive dietary sodium intake is an established risk factor for cardiovascular and renal complications, its potential association with anemia remains largely unexplored.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We hypothesized that, based on the observed benefits of sodium-glucose cotransporter 2 inhibitors in correcting anemia through alterations in renal tubular metabolism and oxygen homeostasis, elevated urinary sodium excretion, as a surrogate of dietary sodium intake, may increase the risk of prevalent anemia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This nationwide cross-sectional study analyzed 54,802 adults from the Korea National Health and Nutrition Examination Survey (2014-2023). Participants were stratified by spot urine sodium-to-creatinine ratio (Na+\/Cr) quartiles (first quartile [Q1], second quartile [Q2], third quartile [Q3], and fourth quartile [Q4]). Anemia was defined as hemoglobin <13 g\/dL for men and <12 g\/dL for women.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Anemia prevalence increased progressively across spot urine Na+\/Cr quartiles (Q1: 925\/13,700, 6.8%, Q2: 1126\/13,701, 8.2%, Q3: 1393\/13,701, 10.2%, and Q4: 1893\/13,700, 13.8%). Multivariable logistic regression demonstrated that participants in the highest quartile had 43% higher odds of anemia compared with the lowest quartile (adjusted odds ratio 1.429, 95% CI 1.269-1.610; P<.001). Each 1-unit log increase in spot urine Na+\/Cr conferred a 67% increase in odds of anemia (adjusted odds ratio 1.674, 95% CI 1.452-1.930; P<.001). Sensitivity analyses using tertiles, quintiles, estimated 24-hour sodium excretion, and restriction to preserved kidney function consistently confirmed these associations.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Higher urinary sodium excretion exhibits a robust, graded association with increased anemia prevalence in the general population. These findings suggest that dietary sodium restriction may provide additional benefits beyond cardiovascular protection.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/88408","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T20:35:06Z","timestamp":1776803706000},"page":"e88408","source":"Crossref","is-referenced-by-count":0,"title":["Urinary Sodium Excretion and the Risk of Prevalent Anemia: Nationwide Population-Based Cross-Sectional Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3076-3466","authenticated-orcid":false,"given":"Sang Heon","family":"Suh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7784-7566","authenticated-orcid":false,"given":"Dohyeon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5758-8189","authenticated-orcid":false,"given":"Seong Kwon","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-1853","authenticated-orcid":false,"given":"Sunyong","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3540-9004","authenticated-orcid":false,"given":"Soo Wan","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041809"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1804281"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.030099"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.055"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010070.pub3"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1811744"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204233"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038881"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005070757"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2021025"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt228"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2015.07.006"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-83205-0"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060119"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3841"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v009.i08"},{"key":"ref18","author":"Little, RJ","year":"1987","journal-title":"Statistical Analysis with Missing Data"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1001307"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12391213"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.107"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/1440-1681.12031"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1093\/function\/zqad031"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-020-0256-y"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1113\/JP274927"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000052623.16194.80"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.01.070"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad235"},{"key":"ref30","unstructured":"Are you subject to investigation?KNHANES2025-05-25https:\/\/knhanes.kdca.go.kr\/knhanes\/main.do"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2026\/1\/e88408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:15:03Z","timestamp":1782839703000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2026\/1\/e88408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":30,"URL":"https:\/\/doi.org\/10.2196\/88408","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.88408","asserted-by":"object"}]},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]}}}