Renal hemodynamic and tubular responses to salt in women using oral contraceptives


Serval ID
Article: article from journal or magazin.
Renal hemodynamic and tubular responses to salt in women using oral contraceptives
Kidney International
Pechere-Bertschi  A., Maillard  M., Stalder  H., Bischof  P., Fathi  M., Brunner  H. R., Burnier  M.
0085-2538 (Print)
Publication state
Issued date
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Oct
BACKGROUND: The use of oral contraceptives is associated with an increased risk of developing hypertension but the mechanisms of this hypertensive effect are not completely defined. The purpose of the present study was to assess prospectively the systemic and renal hemodynamic and tubular responses to salt in women taking oral contraceptives. METHODS: Twenty seven young healthy normotensive women taking oral contraceptives containing monophasic combination of 30 microg ethynilestradiol and 150 microg desogestrel for>6 months were enrolled. All women were assigned at random to receive a low (40 mmol/day) or a high (250 mmol/day) sodium diet for 1 week on two consecutive menstrual cycles during the active oral contraceptive phase. At the end of each diet period, 24-hour ambulatory blood pressure, renal hemodynamics, sodium handling, and hormonal profile were measured. RESULTS: The blood pressure response to salt on oral contraceptives was characterized by a salt-resistant pattern with a normal circadian rhythm. Salt loading results in an increase in glomerular filtration rate (GFR) (P < 0.05 vs. low salt), with no change in the renal plasma flow, thus leading to an increase in the filtration fraction (P < 0.05). At the tubular level, women on oral contraceptives responded to a low salt intake with a marked increased in proximal sodium conservation (P < 0.01 vs. high salt) and with an almost complete reabsorption of sodium reaching the distal tubule. After sodium loading, both the proximal and the distal reabsorption of sodium decreased significantly (P < 0.01). CONCLUSION: The use of oral contraceptives is not associated with an increased blood pressure response to salt in young normotensive women. However, oral contraceptives affect the renal hemodynamic response to salt, a high salt intake leading to an increase in GFR and filtration fraction. This effect is possibly mediated by the estrogen-induced activation of the renin-angiotensin system. Oral contraceptives also appear to increase the tubular responsiveness to changes in sodium intake. Taken together, these data point out evidence that synthetic sex steroids have a significant impact on renal function in women. The renal effects of oral contraceptives should be taken into account when managing young women with renal diseases.
Adult Blood Pressure/drug effects Contraceptives, Oral/*pharmacology Drug Synergism Female Heart Rate/drug effects Hemodynamic Phenomena/drug effects Hormones/blood Humans Kidney/metabolism Kidney Tubules/*drug effects Renal Circulation/*drug effects Sodium/metabolism Sodium Chloride/*pharmacology
Web of science
Open Access
Create date
25/01/2008 13:59
Last modification date
20/08/2019 13:30
Usage data