From the Division of Nephrology and Hypertension (D.A.J., A.P.-B., B.P.), Geneva University Hospitals, Switzerland.
Division of Nephrology and Hypertension, Lausanne University Hospitals, Switzerland (M.P., M.B.).
Hypertension. 2020 Dec;76(6):1898-1905. doi: 10.1161/HYPERTENSIONAHA.120.15932. Epub 2020 Oct 5.
Renal resistive index (RRI) has been associated with adverse renal and cardiovascular outcomes. Although traditionally considered a marker of intrinsic renal damage, RRI could also reflect systemic vascular dysfunction. As sodium intake was linked to alterations in vascular properties, we wished to characterize the association of salt consumption with RRI in the general adult population. Participants were recruited in a population-based study in Switzerland. RRI was measured by ultrasound in 3 segmental arteries. Sodium intake (UNa; mmol/24 h) was estimated on 24-hour urine samples. Carotido-femoral pulse wave velocity was obtained by applanation tonometry. Mixed multivariate regression models were used with RRI or pulse wave velocity as independent variables and UNa as dependent variable, adjusting for possible confounders. We included 1002 patients in the analyses with 528 (52.7%) women and mean age of 47.2±17.4. Mean values of UNa and RRI were 141.8±61.1 mmol/24 h and 63.8±5.5%, respectively. In multivariate analysis, UNa was positively associated with RRI (=0.002) but not with pulse wave velocity (=0.344). Plasma renin activity and aldosterone did not modify the relationship between UNa and RRI (=0.087 for interaction). UNa/urinary potassium ratio was positively associated with pulse wave velocity ≥12 m/s (=0.033). Our results suggest that dietary salt consumption has a direct impact on renal hemodynamic in the adult general population. Alterations in vascular properties likely explain those findings, but inadequate renal vaso-motor response is also possible. Sodium intake could thus potentially be linked to underlying structural systemic damages affecting this population.
肾血管阻力指数(RRI)与不良的肾脏和心血管结局相关。尽管传统上认为 RRI 是内在肾脏损伤的标志物,但它也可能反映全身血管功能障碍。由于钠的摄入与血管特性的改变有关,我们希望在一般成年人群中描述盐摄入量与 RRI 的关系。参与者是在瑞士的一项基于人群的研究中招募的。RRI 通过超声在 3 个节段性动脉中进行测量。通过 24 小时尿液样本估计钠摄入量(UNa;mmol/24 h)。通过平板测压法获得颈股脉搏波速度。使用多元混合回归模型,将 RRI 或脉搏波速度作为自变量,UNa 作为因变量进行分析,调整可能的混杂因素。我们纳入了 1002 名患者进行分析,其中 528 名(52.7%)为女性,平均年龄为 47.2±17.4 岁。UNa 和 RRI 的平均值分别为 141.8±61.1 mmol/24 h 和 63.8±5.5%。在多变量分析中,UNa 与 RRI 呈正相关(=0.002),但与脉搏波速度无关(=0.344)。血浆肾素活性和醛固酮并没有改变 UNa 和 RRI 之间的关系(=0.087 交互作用)。UNa/尿钾比值与脉搏波速度≥12 m/s 呈正相关(=0.033)。我们的研究结果表明,膳食盐的摄入对一般成年人群的肾脏血液动力学有直接影响。血管特性的改变可能解释了这些发现,但也可能存在肾脏血管舒缩反应不足。因此,钠的摄入可能与影响该人群的潜在结构性系统性损伤有关。