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<p>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.</p>

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

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月5日

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  • Jonas Wuopio,
  • Lin Yi-Ting,
  • Koen F. Dekkers,
  • Tove Fall,
  • J. Gustav Smith,
  • Anders Larsson,
  • Gunnar Engström,
  • Marju Orho-Melander,
  • Linda Johnson,
  • Johan Ärnlöv

摘要

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.