Kidneys intertwined with sodium and potassium symbols with subtle uric acid crystal formation.

Kidney Health Alert: Are Sodium and Potassium Levels Affecting Your Uric Acid?

Samir D’Costa in Health & Wellness August 2025 • 4 min read.

"New research reveals the critical link between sodium, potassium, and uric acid excretion in chronic kidney disease, particularly for those with hypertension. Learn how to manage your diet for better kidney health."

If you're managing chronic kidney disease (CKD), you’re likely familiar with the constant balancing act required to maintain your health. Among the many factors to consider, the relationship between hypertension, hyperuricemia (high uric acid levels), and the excretion of key minerals like sodium and potassium plays a crucial role. Recent studies shed light on how these elements interact, particularly in individuals with CKD.

Hypertension and hyperuricemia often go hand-in-hand, creating a complex cycle of cause and effect. High blood pressure can impact kidney function, leading to reduced uric acid excretion, which in turn can exacerbate hyperuricemia. Adding another layer to this intricate web, sodium and potassium levels—influenced by diet—can significantly affect blood pressure and kidney health.

New research published in Kidney Blood Pressure Research uncovers critical associations between urinary sodium and potassium excretion and renal uric acid handling in CKD patients. This article translates these findings into actionable insights, offering a clear understanding of how your dietary choices can impact your kidney health and uric acid levels.

The Sodium-Potassium-Uric Acid Connection: What the Study Revealed?

Kidneys intertwined with sodium and potassium symbols with subtle uric acid crystal formation.

The study, conducted with 428 CKD patients, explored the correlation between urinary sodium and potassium levels and how the kidneys handle uric acid. Patients were divided into two groups: those with hypertension and those without. Researchers used sophisticated statistical methods to analyze the relationships between these factors.

Here’s a breakdown of the key findings:

Hypertension Matters: In hypertensive patients, higher fractional excretion of sodium (FEna) was linked to lower levels of uric acid in urine (24-hUur) and reduced uric acid clearance (Cur). Conversely, FEna was positively correlated with the fractional excretion of uric acid (FEur).
Potassium's Role: Fractional excretion of potassium (FEk) also showed a positive correlation with FEur in hypertensive individuals.
Sodium-Potassium Ratio: A higher urinary sodium/potassium ratio (Una/k) was associated with lower 24-h Uur and Cur but higher FEur.
eGFR Impact: The relationships between FEna, FEk, and FEur were most pronounced in patients with lower estimated glomerular filtration rates (eGFR), indicating that kidney function significantly influences these dynamics.
Non-Hypertensive Differences: In non-hypertensive patients, a higher FEna was only linked to lower 24-h Uur, with no significant relationships observed for Cur or FEur.

These results highlight that in CKD patients, particularly those with hypertension and reduced kidney function, the way the body handles sodium and potassium is closely tied to uric acid excretion. This suggests that managing sodium and potassium intake could be a valuable strategy for controlling uric acid levels and overall kidney health.

Practical Steps for Managing Your Kidney Health

Understanding the connection between sodium, potassium, and uric acid can empower you to make informed dietary choices that support your kidney health. Here are some practical steps to consider:

About this Article -

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Everything You Need To Know

What is the relationship between hypertension, hyperuricemia, sodium, and potassium in chronic kidney disease?

Chronic Kidney Disease (CKD) involves a delicate balance, especially concerning hypertension, hyperuricemia (high uric acid), and key minerals like sodium and potassium. Hypertension can impair kidney function, reducing uric acid excretion and worsening hyperuricemia. Sodium and potassium levels, influenced by diet, significantly affect blood pressure and kidney health, creating a complex interaction crucial for managing CKD.

What were the main findings of the study on sodium, potassium, and uric acid in CKD patients?

The study revealed several key connections. In hypertensive patients, higher fractional excretion of sodium (FEna) was linked to lower uric acid in urine and reduced uric acid clearance (Cur). Fractional excretion of potassium (FEk) also showed a positive correlation with the fractional excretion of uric acid (FEur) in hypertensive individuals. A higher urinary sodium/potassium ratio (Una/k) was associated with lower 24-h Uur and Cur but higher FEur. The relationships between FEna, FEk, and FEur were most pronounced in patients with lower estimated glomerular filtration rates (eGFR). In non-hypertensive patients, a higher FEna was only linked to lower 24-h Uur, with no significant relationships observed for Cur or FEur.

What is fractional excretion of sodium (FEna), and why is it important?

Fractional excretion of sodium (FEna) represents the proportion of sodium filtered by the kidneys that is excreted in the urine. It helps assess how well the kidneys are handling sodium. In hypertensive patients, a higher FEna was linked to lower levels of uric acid in urine and reduced uric acid clearance, suggesting the kidneys' sodium handling affects uric acid excretion. FEna is important because it indicates how efficiently the kidneys regulate sodium, which is crucial for blood pressure control and overall kidney health.

What is the urinary sodium/potassium ratio, and why should it be monitored?

The urinary sodium/potassium ratio (Una/K) is the ratio between the amount of sodium and potassium excreted in the urine. A higher Una/K ratio was associated with lower 24-hour Uur (uric acid in urine) and Cur (uric acid clearance) but higher FEur (fractional excretion of uric acid). This suggests that the balance between sodium and potassium excretion affects how the kidneys handle uric acid. Monitoring and managing this ratio is important because it provides insights into electrolyte balance and kidney function, aiding in dietary adjustments to support kidney health.

What is eGFR, and why is it important in the context of kidney health and this study?

Estimated Glomerular Filtration Rate (eGFR) is a measure of how well your kidneys are filtering blood. A lower eGFR indicates reduced kidney function. The study found that the relationships between fractional excretion of sodium (FEna), fractional excretion of potassium (FEk), and fractional excretion of uric acid (FEur) were most pronounced in patients with lower eGFR. This indicates that kidney function significantly influences these dynamics. Monitoring eGFR is essential because it helps assess the severity of kidney disease and guide treatment strategies.