Prognostic Significance of Spot Urine Na/K for Longitudinal Changes in Blood Pressure and Renal Function: The Nagahama Study
Prognostic Significance of Spot Urine Na/K for Longitudinal Changes in Blood Pressure and Renal Function: The Nagahama Study
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DOI：
10.1093/ajh/hpx075
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发表时间：
2017-09-01
影响因子：
3.2
通讯作者：
Matsuda, Fumihiko
中科院分区：
文献类型：
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作者：
Tabara, Yasuharu;Takahashi, Yoshimitsu;Matsuda, Fumihiko
基础尿钠钾比（Na/K）是钠负荷的一种简单测量方法，据报道，即使在现场测量的情况下，也与横截面设置中的血压（BP）水平相关。本大规模队列研究的目的是确定尿钠/钾的BP水平和肾功能的纵向变化的预后意义。METHODS本研究人群包括7,063人从一般人群。在基线和5年的随访期间测量临床参数。平均收缩压在随访期间略有增加（总体为124 +/- 17至125 +/- 18 mm Hg;未治疗的参与者为119 +/- 15至122 +/- 17 mm Hg）。尽管在横断面分析中尿Na/K与BP呈线性相关（P < 0.001），但对重复测量的BP值的分析确定了基线Na/K* 时间相互作用，即，个体内效应，作为独立于高血压状态和空腹状态的逆决定因素（F = 76.9，P < 0.001），可能是由于基线时暂时高基线Na/K值的平均值回归。横断面分析发现尿Na/K值与肾功能呈正相关（P < 0.001）。虽然基线Na/K* 时间相互作用显示与肾功能下降呈负相关（F = 85.8，P < 0.001），但这种负相关可能并不代表与BP分析同样的生理关系。
BACKGROUNDUrinary sodium-to-potassium ratio (Na/K) represents a simple measure of sodium load and has been reported to be associated with blood pressure (BP) levels in a cross-sectional setting even with spot measurements. The aim of the present large-scale cohort study is to determine prognostic significance of spot urine Na/K for longitudinal changes in BP levels and renal function.METHODSThe present study population consisted of 7,063 individuals from the general population. Clinical parameters were measured at baseline and at a follow-up interval of 5 years.RESULTSMean systolic BP was slightly increased during the follow-up period (overall, 124 +/- 17 to 125 +/- 18 mm Hg; nontreated participants, 119 +/- 15 to 122 +/- 17 mm Hg). Although, the urinary Na/K demonstrated a linear association with BP in a cross-sectional analysis (P < 0.001), analysis of repeated measured BP values identified baseline Na/K* time interaction, i.e., an intraindividual effect, as an inverse determinant (F = 76.9, P < 0.001) independently of hypertension status and fasting conditions possibly due to regression to the mean of temporary high baseline Na/K values at baseline. Spot urine Na/K values were found to be positively associated with renal function in a cross-sectional analysis (P < 0.001). Although baseline Na/K* time interaction showed inverse associated with renal functional decline (F = 85.8, P < 0.001), this inverse association might not represent physiological relationship in likewise fashion with the analysis for BP.CONCLUSIONSSpot urine Na/K may have limited utility as a prognostic marker of longitudinal BP change, as well as renal functional decline.