Complex Hypertension Service, UCL Department of Renal Medicine, University College London, London, UK.
UCL Department of Medicine, University College London, London, UK.
Am J Hypertens. 2019 Sep 24;32(10):983-991. doi: 10.1093/ajh/hpz104.
Sodium intake is correlated with the development of hypertension. Guyton's principals suggest that the 24-hour urinary sodium excretion reflects sodium ingestion over the same period. 24-hour urine collections are arduous to collect, so many centers use spot urinary measurements instead. We compared spot to matched 24-hour urinary electrolyte measurements.
We examined 419 hypertensive patients from the UCL Complex Hypertension Clinic. 77 had matched and complete 24-hour and spot urinary and serum biochemistry to examine.We compared the spot and 24-hour urinary; sodium concentration, Na/Cr ratio, FENa, Kawasaki and Tanaka estimated sodium excretion as well as the potassium concentration, K/Cr ratio, Kawasaki and Tanaka potassium excretion.
Our cohort was 58% male and the median age was 41 years. The 24-hour and spot Na concentrations correlated moderately (r = 0.4633, P < 0.0001). The 24-hour and spot Na/creatinine ratios correlated weakly (r = 0.2625, P = 0.0194). The 24-hour and spot FENa results showed a weak negative correlation (r = -0.222, P = ns). The 24-hour sodium excretion and the Kawasaki-derived spot urine sodium excretion correlated moderately (r = 0.3118, P = 0.0052). All Bland-Altman analyses showed poor agreement.The 24-hour and spot potassium concentrations correlated very poorly (r = 0.1158, P = ns). The 24-hour and spot urinary K/creatinine ratios correlated weakly (r = 0.47, P ≤ 0.0001). 24-hour and Kawasaki and Tanaka estimated potassium excretions correlated much better (r = 0.58, P < 0.0001).
Spot urinary measurements of sodium give a very poor understanding of the natriuresis occurring over the same 24-hour period. The Kawasaki and Tanaka estimations of the 24-hour sodium excretion showed a much lower correlation than previously reported.
钠摄入量与高血压的发生有关。盖顿的原理表明，24 小时尿钠排泄量反映了同一时期的钠摄入量。24 小时尿收集很困难，因此许多中心使用随机尿测量值代替。我们比较了随机尿和匹配的 24 小时尿电解质测量值。
我们检查了来自 UCL 复杂高血压诊所的 419 名高血压患者。77 名患者有匹配且完整的 24 小时和随机尿以及血清生化检查，以检查。我们比较了随机尿和 24 小时尿；钠浓度、Na/Cr 比值、FENa、川崎和田中估计的钠排泄量以及钾浓度、K/Cr 比值、川崎和田中钾排泄量。
我们的队列中 58%为男性，中位年龄为 41 岁。24 小时和随机尿钠浓度中度相关（r = 0.4633，P < 0.0001）。24 小时和随机尿 Na/Cr 比值弱相关（r = 0.2625，P = 0.0194）。24 小时和随机尿 FENa 结果呈弱负相关（r = -0.222，P = ns）。24 小时钠排泄量和川崎法估计的随机尿钠排泄量中度相关（r = 0.3118，P = 0.0052）。所有 Bland-Altman 分析均显示一致性差。24 小时和随机尿钾浓度相关性差（r = 0.1158，P = ns）。24 小时和随机尿 K/Cr 比值弱相关（r = 0.47，P ≤ 0.0001）。24 小时和川崎和田中估计的钾排泄量相关性更好（r = 0.58，P < 0.0001）。
随机尿钠测量值对同一 24 小时内的钠排泄情况了解甚少。川崎和田中对 24 小时钠排泄量的估计与以前报道的相关性要低得多。
