Koo Ho Seok, Kim Yong Chul, Ahn Shin Young, Oh Se Won, Kim Suhnggwon, Chin Ho Jun
Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. ; The Research Institute for Salt and Health, Seongnam, Korea.
The Research Institute for Salt and Health, Seongnam, Korea. ; Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.
J Korean Med Sci. 2014 Sep;29 Suppl 2(Suppl 2):S117-22. doi: 10.3346/jkms.2014.29.S2.S117. Epub 2014 Sep 30.
We investigated the association between 24-hr urinary sodium (24UNA) and adequacy of blood pressure (BP) control in patients with chronic kidney disease (CKD) and nonCKD. All data were collected retrospectively by accessing the electrical medical records in patients with 24-hr urine collection and serum creatinine. Enrolled 400 subjects were subgrouped by the amount of 24UNA, or CKD stage. The appropriate BP was defined as BP < 130/80 mmHg for subjects with proteinuria, and BP < 140/90 mmHg for subjects without proteinuria. The mean level of 24UNA was 166±76 mEq/day. The 24UNA group was an independently related factor to diastolic BP as a continuous variable. The rate of appropriate BP control in patients with proteinuria was highest in 24UNA <100 mEq/L (P=0.012). The odds to fail achievement of BP target in subjects with 24UNA≥90 mEq/day was 2.441 (1.249-4.772, P=0.009) higher than that of 24UNA <90 mEq/day among participants with proteinuria. There was difference in the amount of 24UNA between CKD and non-CKD except each stage of CKD group. In conclusion, salt intake estimated by 24-hr urine sodium excretion is a risk factor to achieve appropriate BP control.
我们研究了慢性肾脏病(CKD)和非CKD患者24小时尿钠(24UNA)与血压(BP)控制达标之间的关联。通过查阅有24小时尿收集和血清肌酐检查的患者的电子病历,回顾性收集所有数据。纳入的400名受试者按24UNA量或CKD分期进行亚组分析。蛋白尿患者的合适血压定义为BP<130/80 mmHg,无蛋白尿患者的合适血压定义为BP<140/90 mmHg。24UNA的平均水平为166±76 mEq/天。24UNA组作为连续变量是舒张压的独立相关因素。蛋白尿患者中,24UNA<100 mEq/L时血压控制达标的比例最高(P=0.012)。在蛋白尿患者中,24UNA≥90 mEq/天的受试者未达到血压目标的几率比24UNA<90 mEq/天的受试者高2.441(1.249 - 4.772,P=0.009)。除CKD组各阶段外,CKD和非CKD患者的24UNA量存在差异。总之,通过24小时尿钠排泄估算的盐摄入量是实现合适血压控制的一个危险因素。