Proximal sodium reabsorption: An independent determinant of blood pressure response to salt.

Details

Serval ID
serval:BIB_C30DB52DD7EE
Type
Article: article from journal or magazin.
Collection
Publications
Title
Proximal sodium reabsorption: An independent determinant of blood pressure response to salt.
Journal
Hypertension
Author(s)
Chiolero A., Maillard M., Nussberger J., Brunner H.R., Burnier M.
ISSN
1524-4563[electronic]
Publication state
Published
Issued date
2000
Volume
36
Number
4
Pages
631-7
Language
english
Notes
Publication types: Clinical Trial ; Controlled Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
The purpose of this study was to evaluate the contribution of renal sodium handling by the proximal tubule as an independent determinant of blood pressure responsiveness to salt in hypertension. We measured blood pressure (BP), renal hemodynamics, and segmental renal sodium handling (with lithium used as a marker of proximal sodium reabsorption) in 38 hypertensive patients and 27 normotensive subjects (15 young and 12 age-matched) on a high and low sodium diet. In control subjects, changing the diet from a low to a high sodium content resulted in no change in BP and increases in glomerular filtration rate (P<0.05), renal plasma flow (P<0.05), and fractional excretion of lithium (FE(Li), P<0.01). In hypertensive patients, comparable variations of sodium intake induced an increase in BP with no change in renal hemodynamics and proximal sodium reabsorption. When analyzed by tertiles of their BP response to salt, salt-insensitive hypertensive patients of the first tertile disclosed a pattern of adaptation of proximal sodium reabsorption comparable to that of control subjects, whereas the most salt-sensitive patients of the third tertile had an inverse pattern with a high FE(Li) on low salt and a lower FE(Li) on high salt, suggesting an inappropriate modulation of proximal sodium reabsorption. The BP response to salt correlated positively with age (r=0.34, P=0.036) and negatively with the changes in FE(Li) (r=-0.37, P=0.029). In a multivariate analysis, the changes in FE(Li) were significantly and independently associated with the salt-induced changes in BP. These results suggest that proximal sodium reabsorption is an independent determinant of the BP response to salt in hypertension.
Keywords
Adult, Aldosterone, Blood Pressure, Body Weight, Dose-Response Relationship, Drug, Electrolytes, Female, Glomerular Filtration Rate, Hemodynamics, Humans, Hypertension, Kidney Tubules, Proximal, Lithium, Male, Middle Aged, Multivariate Analysis, Natriuresis, Renal Blood Flow, Effective, Renin, Sodium, Sodium, Dietary
Pubmed
Web of science
Create date
05/03/2008 17:41
Last modification date
20/08/2019 16:38
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