Appropriate use of spot-urine sodium estimates for population-level and exploratory analyses: a response to Campbell and Cappuccio

Nutrition & Metabolism 2026 Open access

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Authors: Jonas Wuopio, Lin Yi-Ting, Koen F. Dekkers, Tove Fall, J. Gustav Smith, A. Larsson, Gunnar Engström, Marju Orho-Melander, L S B Johnson, Johan Ärnlöv
DOI: 10.1186/s12986-025-01056-2
Cited by: 1
References: 12

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.

Fields of Study & Subjects

Sodium Intake and Health Nutritional Studies and Diet Renal function and acid-base balance

Publication details

Journal / source
Nutrition & Metabolism
Publisher
Springer Science and Business Media LLC
Volume
23
Issue
1
Pages
18–18
Publication date
5 February 2026
Language
EN