Ramesh Prasad G V, Huang Michael, Nash Michelle M, Zaltzman Jeffrey S
Renal Transplant Program, St Michael's Hospital, Toronto, ON, Canada.
Clin Transplant. 2006 Jan-Feb;20(1):37-42. doi: 10.1111/j.1399-0012.2005.00437.x.
The role of dietary cations in hypertension has been evaluated in the general population and selected subgroups, but its contribution to blood pressure (BP) elevations in patients with functional renal allografts has not been critically examined.
After counseling based on Dietary Approaches to Stop Hypertension (DASH) guidelines, we measured timed 24-h urine excretion rates of sodium, potassium, calcium, and magnesium as a surrogate for their dietary intake, in 244 stable adult single-organ renal transplant recipients, correlating these with averaged blinded clinic-measured BP values. Multiple linear regression analysis adjusting for factors affecting BP in transplant recipients was performed.
There was no correlation between systolic (SBP) or diastolic pressure (DBP) and 24-h urine excretion rates of each cation. There was no BP difference between patients receiving cyclosporine and tacrolimus (127/77 vs. 129/78 mmHg, p = 0.38), or in cation excretion except for calcium (2.85 +/- 2.0 vs. 2.90 +/- 2.8, p = 0.002). Protein excretion (p < 0.0001), age (p = 0.002), and weight (p = 0.04) were positively associated with SBP, while only weight (p = 0.01) was associated with DBP by multivariate analysis.
Dietary cation intake is not significantly associated with BP in renal transplant recipients. These data do not support recommendations to alter dietary cation intake as part of the management of post-transplantation hypertension.
膳食阳离子在高血压中的作用已在普通人群和特定亚组中进行了评估，但尚未对其在功能性肾移植患者血压（BP）升高中的作用进行严格审查。
根据高血压防治饮食法（DASH）指南进行咨询后，我们测量了244例稳定的成年单器官肾移植受者的钠、钾、钙和镁的24小时定时尿排泄率，以此作为其膳食摄入量的替代指标，并将这些指标与平均的、经盲法测量的临床血压值相关联。对影响移植受者血压的因素进行了多元线性回归分析。
收缩压（SBP）或舒张压（DBP）与每种阳离子的24小时尿排泄率之间均无相关性。接受环孢素和他克莫司的患者之间血压无差异（127/77 vs. 129/78 mmHg，p = 0.38），除钙外的阳离子排泄也无差异（2.85±2.0 vs. 2.90±2.8，p = 0.002）。蛋白质排泄（p < 0.0001）、年龄（p = 0.002）和体重（p = 0.04）与SBP呈正相关，而多变量分析显示只有体重（p = 0.01）与DBP相关。
肾移植受者的膳食阳离子摄入量与血压无显著相关性。这些数据不支持作为移植后高血压管理一部分而改变膳食阳离子摄入量的建议。
