Appropriate use of spot-urine sodium estimates for population-level and exploratory analyses: a response to Campbell and Cappuccio
Year: 2026
Type: article
Abstract: In response to Campbell and Cappuccio's comments, this letter clarifies and defends the appropriate use of spot-urine sodium estimates in population-level and exploratory analyses. The critique misrepresents key aspects of the study design and overstates the limitations of spot-urine equations. While acknowledging that these methods are unsuitable for precise individual assessment, they perform adequately for ranking individuals and examining population-level associations, as supported by extensive validation studies. The reported associations with metabolic traits were internally consistent, biologically plausible, and in agreement with findings from studies using 24-hour urine collections. Dismissing such analyses as "invalid" undermines constructive scientific dialogue and disregards the exploratory value of transparent, hypothesis-generating research.
Source: Nutrition & Metabolism
Institutions: Uppsala University, Karolinska Institutet, Center for Clinical Research Dalarna, Kaohsiung Medical University, Kaohsiung Medical University Chung-Ho Memorial Hospital, Lund University, Sahlgrenska University Hospital, Skåne University Hospital, University of Gothenburg, Population Health Research Institute, McMaster University, Dalarna University
Language: English
Topic: Sodium Intake and Health
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,590
OpenAlex ID: W7127913149