Correlation between kidney sodium and potassium handling and the renin-angiotensin-aldosterone system in children with hypertensive disorders.
Correlation between kidney sodium and potassium handling and the renin-angiotensin-aldosterone system in children with hypertensive disorders.
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DOI：
10.1007/s00467-021-05204-7
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
South AM
中科院分区：
文献类型：
--
作者：
Perrin EC;South AM
尿钠和钾被用作成人高血压患者饮食消耗的替代标志物，但其在青年高血压患者中的作用及其与肾素-血管紧张素-醛固酮系统（RAAS）组分的相关性尚不完全清楚。一些高血压患者可能对膳食钠和钾摄入量有异常的RAAS反应，尽管这一点描述不完整。我们的目的是调查是否血浆肾素活性和血清醛固酮与尿钠和尿钾的高血压疾病的青年转介。这项初步研究是一项横断面分析的基线数据，从44名青年评估高血压疾病的高血压诊所。我们记录了尿钠和钾浓度，标准化为尿肌酐、血浆肾素活性和血清醛固酮，并计算钠/钾（UNaK）和醛固酮/肾素比值。我们使用多变量广义线性模型来估计肾素和醛固酮与尿钠和尿钾的关系。我们的队列是多样化的（37%非西班牙裔黑人，14%西班牙裔），66%是男性，中位年龄为15.3岁; 77%有肥胖，9%有继发性病因。校正估计的肾小球滤过率和血清钾后，醛固酮与尿钠/肌酐（β：-0.34，95%CI-0.62至-0.06）和UNa K（β：-0.09，95%CI-0.16至-0.03）呈负相关。在高血压患者中，较高的血清醛固酮水平与较低的尿钠/肌酐和UNaK相关，但与血浆肾素活性无关。RAAS的进一步表征有助于确定高血压表型和指导治疗。
Urine sodium and potassium are used as surrogate markers for dietary consumption in adults with hypertension, but their role in youth with hypertension and their association with components of the renin-angiotensin-aldosterone system (RAAS) are incompletely characterized. Some individuals with hypertension may have an abnormal RAAS response to dietary sodium and potassium intake, though this is incompletely described. Our objective was to investigate if plasma renin activity and serum aldosterone are associated with urine sodium and potassium in youth referred for hypertensive disorders. This pilot study was a cross-sectional analysis of baseline data from 44 youth evaluated for hypertensive disorders in a Hypertension Clinic. We recorded urine sodium and potassium concentrations normalized to urine creatinine, plasma renin activity, and serum aldosterone and calculated the sodium/potassium (UNaK) and aldosterone/renin ratios. We used multivariable generalized linear models to estimate the associations of renin and aldosterone with urine sodium and potassium. Our cohort was diverse (37% non-Hispanic Black, 14% Hispanic), 66% were male, and median age was 15.3 years; 77% had obesity and 9% had a secondary etiology. Aldosterone was associated inversely with urine sodium/creatinine (β: −0.34, 95% CI −0.62 to −0.06) and UNaK (β: −0.09, 95% CI −0.16 to −0.03), adjusted for estimated glomerular filtration rate and serum potassium. Higher serum aldosterone levels, but not plasma renin activity, were associated with lower urine sodium/creatinine and UNaK at baseline in youth referred for hypertensive disorders. Further characterization of the RAAS could help define hypertension phenotypes and guide management.
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影响因子：
8.3
作者：
Faulkner, Jessica L.;Harwood, Daisy;de Chantemele, Eric J. Belin
通讯作者：
de Chantemele, Eric J. Belin
影响因子：
4.9
作者：
Cohen JB;D'Agostino McGowan L;Jensen ET;Rigdon J;South AM
通讯作者：
South AM
影响因子：
8
作者：
Barlow, Sarah E.
通讯作者：
Barlow, Sarah E.
影响因子：
7.1
作者：
PIETINEN, PI;WONG, O;ALTSCHUL, AM
通讯作者：
ALTSCHUL, AM
影响因子：
2.5
作者：
Dibo, Paula;Maranon, Rodrigo O.;Juncos, Luis, I
通讯作者：
Juncos, Luis, I