Urine conductivity as a screening test to detect an adverse circadian blood pressure profile


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Abstract

Aim. To develop a new marker for early screening for adverse circadian blood pressure profile. Material and methods. The study comprised 375 patients who self-referred to the Health centre. The mean age of the patients was 46±8 years. All patients reported salt consumption of over 6 g/day, 56% of them had abdominal obesity. «Office» bp measurements showed mean SBP 144±12.8 mm HG and DBP 89±7 mm HG. 36%, і9.2%, 42.4% and 2.4% of patients had «non-dipper», «night-peaker», «dipper» and «over-dipper» circadian blood pressure profiles, respectively. Urine conductivity and natriuresis were measured in a single urine sample collected in the morning (08: 00-10: 00), DAYTIME (12: 00-14: 00) AND EVENING (18: 00-20: 00) HOURS. Results. The findings showed interrelationship between natriuresis and urine conductivity: correlation coefficients between natriuresis and urine conductivity in the morning, daytime and evening urine samples were R=0.987, P<0.0001, R=0.982, P<0.0001 AND R=0.989, P<0.0001, RESPECTIVELY. PATIENTS WITH «NIGHT-PEAKER» AD profile were found to have a sharp rise in the level of natriuresis and urine conductivity («peak»). Examining the likelihood of adverse circadian blood pressure profile depending on the «peak» of sodium excretion and urine conductivity showed that evening «peak» of natriuresis and urine conductivity increases the possibility of 24-hour «night-peaker» (to a greater extent) and «non-dipper» ad profiles. Conclusion. Natriuresis, which reflects the functional state of renal TIT and its circadian disturbances, is able to most fully reveal the risk of adverse blood pressure profile. Screening of natriuresis by measuring urine conductivity in the evening hours allows adverse blood pressure profiles to be predicted with high probability.

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References

  1. Charlton K.E., Steyn K., Levitt N.S., Jonathan D., Zulu J.V., Nel J.H. Development and validation of a short questionnaire to assess sodium intake. Public Health Nutr. 2008; 11(01): 83-94.
  2. Чазова И.Е. Национальные рекомендации по диагностике и лечению метаболического синдрома. Кардиоваскулярная терапия и профилактика. 2007; 6(6): Приложение 2.
  3. Dyer A.R., Stamler R., Grimm R., Stamler J., Berman R., Gosch F.C., Emidy L.A., Elmer P., Fishman J., Van Heel N., et al. Do hypertensive patients have a different diurnal pattern of electrolyte excretion? Hypertension. 1987; 10(4): 417-424.
  4. Fukuda M., Munemura M., Usami T., Nakao N., Takeuchi O., Kamiya Y., Yoshida A., Kimura G. Nocturnal blood pressure is elevated with natriuresis and proteinuria as renal function deteriorates in nephropathy. Kidney Int. 2004; 65(2): 621-625.
  5. Lurbe E., Redon J., Kesani A., Pascual J.M., Tacons J., Alvarez V., Batlle D. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N. Engl. J. Med. 2002; 347(11): 797-805.
  6. Perrin N.E., Torbjörnsdotter T.B., Jaremko G.A., Berg U.B. The course of diabetic glomerulopathy in patients with type I diabetes: A 6-yearfollow-up with serial biopsies. Kidney Int. 2006; 69(4): 699- 705.
  7. Portaluppi F.,Montanari L.,Ferlini M., Vergnani L., D’Ambrosi A.,Cavallini A.R., Bagni B., degli Uberti E. Consistent changes in the circadian rhythms of blood pressure and atrial natriuretic peptide in congestive heart failure. Chronobiol. Int. 1991; 8(5): 432-439.
  8. Kastrup J., Wroblewski H., Sindrup J., Rolighed Christensen H., Wiinberg N. Diurnal blood pressure profile in patients with severe congestive heart failure: dippers and non-dippers. Scand. J. Clin. Lab. Invest. 1993; 53(6): 577-583.
  9. Арутюнов Г.П., Драгунов Д.О., Соколова А.В., Моросанова Е.И. Влияние диуретиков с разным периодом полувыведения на изменение натрийуреза и показатели центральной гемодинамики у пациентов с гипертонической болезнью, осложненной хронической сердечной недостаточностью. Сердце: журнал для практикующих врачей. 2014; 2(13): 107-113.
  10. Davison A.M., Cameron J.S., Grunfeld J.-P., et al. Oxford Textbook of Clinical Nephrology. Oxford University Press, 2005.
  11. Арутюнов Г.П., Драгунов Д.О., Соколова А.В., Арутюнов А.Г. Фракционная экскреция мочевой кислоты как альтернативный маркер низкого уровня натрийуреза. Клиническая нефрология. 2014; 5: 20-24.
  12. Yamamoto K., Takeda Y., Yamashita S., Sugiura T., Wakamatsu Y., Fukuda M., Ohte N., Dohi Y., Kimura G. Renal dysfunction impairscir cadianvariation of endothelial function in patients with essential hypertension. J. Am. Soc. Hypertens. 2010; 4: 265-271. doi: 10.1016/j.jash.2010.09.004.
  13. Fukuda M., Kimura G. Salt Sensitivity and Nondippers in Chronic Kidney Disease. Curr. Hypertens. Rep. 2012; 14(5): 382-387. doi: 10.1007/s11906-012-0286-3.
  14. Miura T., Watanabe S., Urushihara M., Kobori H., Fukuda M. The natriuretic effect of angiotensin receptor blocker sisnotattribu tableto blood pressure reduction during the previous night, but to in hibition of tubular sodium reabsorption. J. Renin. Angiotensin. Aldosterone Syst. 2014; 15: 316-318. doi: 10.1177/1470320313518253.
  15. Арутюнов Г.П., Драгунов Д.О., Соколова А.В. Взаимосвязь между натрийурезом, показателями центральной гемодинамики и плазменной концентрацией ангиотензина II. Клиническая нефрология. 2013; 6: 24-28.
  16. Арутюнов Г.П., Драгунов Д.О., Соколова А.В. Влияние петлевых диуретиков с различным периодом полувыведения на динамику натрийуреза и показатели, характеризующие состояние тубулоинтерстициальной ткани почек. Терапевтический архив. 2014; 86(6): 38-44.

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