Salt Sensitivity and Nondippers in Chronic Kidney Disease

Overview

Journal Curr Hypertens Rep

Specialty Cardiology & Vascular Diseases

Date 2012 Aug 18

PMID 22898905

Citations 5

Authors

Michio Fukuda

Genjiro Kimura

Affiliations

Soon will be listed here.

Abstract

High salt-sensitivity and nondipper blood pressure (BP) rhythm are highly associated with each other, because both are caused by impaired renal sodium excretion capability. We proposed that nocturnal hypertension and resultant pressure natriuresis could compensate for daytime sodium retention. If so, high BP may continue until sodium is sufficiently excreted at night. In fact, it takes longer for the night-time BP to fall in patients with more severe renal dysfunction. The time appears to be an essential component of the nondipper BP rhythm and, therefore, we defined the duration as the dipping time. Also, renal function was the sole determinant of a nocturnal BP dip other than age, sex, or BMI. Furthermore, we reported that diuretic therapy or dietary salt restriction, which can prevent sodium retention, restored the circadian BP rhythm into a dipper pattern. Large-scale studies are needed to explore whether these interventions can decrease the risks.

Citing Articles

Circadian Rhythm of Blood Pressure of Dipper and Non-dipper Patients With Essential Hypertension: A Mathematical Modeling Approach.

Cortes-Rios J, Rodriguez-Fernandez M Front Physiol. 2021; 11:536146.

PMID: 33536928 PMC: 7848196. DOI: 10.3389/fphys.2020.536146.

Association of a Disrupted Dipping Pattern of Blood Pressure with Progression of Renal Injury during the Development of Salt-Dependent Hypertension in Rats.

Sufiun A, Rahman A, Rafiq K, Fujisawa Y, Nakano D, Kobara H Int J Mol Sci. 2020; 21(6).

PMID: 32213948 PMC: 7139748. DOI: 10.3390/ijms21062248.

Sodium balance, circadian BP rhythm, heart rate variability, and intrarenal renin-angiotensin-aldosterone and dopaminergic systems in acute phase of ARB therapy.

Isobe-Sasaki Y, Fukuda M, Ogiyama Y, Sato R, Miura T, Fuwa D Physiol Rep. 2017; 5(11).

PMID: 28576855 PMC: 5471446. DOI: 10.14814/phy2.13309.

Addition of hydrochlorothiazide to angiotensin receptor blocker therapy can achieve a lower sodium balance with no acceleration of intrarenal renin angiotensin system in patients with chronic kidney disease.

Fuwa D, Fukuda M, Ogiyama Y, Sato R, Mizuno M, Miura T J Renin Angiotensin Aldosterone Syst. 2016; 17(2):1470320316652032.

PMID: 27283968 PMC: 4940185. DOI: 10.1177/1470320316652032.

The fixed-dose combination of losartan/hydrochlorothiazide elicits potent blood pressure lowering during nighttime in obese hypertensive patients.

Ibuki C, Seino Y, Otsuka T, Mizuno K J Clin Med Res. 2014; 6(1):8-16.

PMID: 24400025 PMC: 3881983. DOI: 10.4021/jocmr1649w.

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