High salt intake promotes a decline in renal function in hypertensive patients: a 10-year observational study
- 11 October 2012
- journal article
- Published by Springer Science and Business Media LLC in Hypertension Research
- Vol. 36 (2), 172-176
- https://doi.org/10.1038/hr.2012.155
Abstract
We investigated the influence of long-term salt load on renal function in hypertensive patients. The subjects were 133 hypertensive patients (80 women and 53 men, mean age 60±9 years) who underwent at least five successful 24 h home urine collections during the 10-year observation period. Blood pressure (BP) and 24-h urinary salt and creatinine excretion levels were measured. BP decreased from 143±12/85±8 to 129±14/68±11 mm Hg during the 10.5-year observation period, and this decrease was associated with patients taking an increased number of antihypertensive drugs (1.3±1.0 to 2.2±1.1). The estimated glomerular filtration rate (eGFR) also significantly decreased from 71.7±14.6 to 64.7±16.5 ml min(-1) (P<0.01), and the change in eGFR was -0.68 ml min(-1) per year on average. The average salt excretion was 8.6±2.2 g per day and showed a significant negative correlation with the change in eGFR (r=-0.21, P=0.02). Subjects with an average salt excretion<8 g per day showed a significantly slower decline in renal function than those with an average salt excretion 8 g per day (the change in eGFR: -0.41±1.10 vs. -0.83±1.19 ml min(-1) per year, P<0.05). In the multivariate analysis, the average salt excretion (partial r=-0.19, P=0.03) and baseline eGFR (partial r=-0.23, P=0.01) were significantly associated with the change in eGFR. This association was independent of BP change or an increased number of antihypertensive drugs. The results suggest that long-term salt load promotes a decline in renal function in hypertensive patients; thus, salt restriction is encouraged, to prevent renal damage.Keywords
This publication has 27 references indexed in Scilit:
- Increased glomerular filtration rate in early metabolic syndrome is associated with renal adiposity and microvascular proliferationAmerican Journal of Physiology-Renal Physiology, 2011
- Association of Uric Acid With Change in Kidney Function in Healthy Normotensive IndividualsAmerican Journal of Kidney Diseases, 2010
- Associations of Diet with Albuminuria and Kidney Function DeclineClinical Journal of the American Society of Nephrology, 2010
- Erratum to: Prevalence of chronic kidney disease in the Japanese general populationClinical and Experimental Nephrology, 2009
- Vascular consequences of dietary salt intakeAmerican Journal of Physiology-Renal Physiology, 2009
- Revised Equations for Estimated GFR From Serum Creatinine in JapanAmerican Journal of Kidney Diseases, 2009
- The progression of chronic kidney disease: A 10-year population-based study of the effects of gender and ageKidney International, 2006
- Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureHypertension, 2003
- Blood Pressure Predicts Risk of Developing End-Stage Renal Disease in Men and WomenHypertension, 2003
- Simple portable device for sampling a whole day's urine and its application to hypertensive outpatients.Hypertension, 1983