This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Burnier, M. Articles by Brunner, H. R. Search for Related Content PubMed PubMed Citation Articles by Burnier, M. Articles by Brunner, H. R.

Hypertension, Vol 23, 496-502, Copyright © 1994 by American Heart Association

ARTICLES

Renal sodium handling in patients with untreated hypertension and white coat hypertension

M Burnier, J Biollaz, JL Magnin, M Bidlingmeyer and HR Brunner
Policlinique Medicale Universitaire, Division of Hypertension, Lausanne, Switzerland.

Renal tubular sodium handling was investigated prospectively in 48 normotensive subjects, 53 untreated hypertensive patients, and 13 patients with white coat hypertension using endogenous trace lithium as a marker of proximal sodium reabsorption. A 12-hour daytime ambulatory blood pressure recording was performed in all patients to confirm the diagnosis of hypertension. Patients were included in the white coat hypertension group if their office blood pressure was above 160/90 mm Hg but the mean value of their 12-hour ambulatory recording was lower than 140/90 mm Hg. All participants were studied on their normal diet and ate salt freely. Fractional excretions of sodium (FENa), lithium (FELi), and potassium (FEK) were measured simultaneously before blood pressure recording. FENa was significantly higher in hypertensive patients (0.84 +/- 0.05%, P < .05) than in normotensive control subjects (0.60 +/- 0.06%), and FELi was comparable in the two groups (15.4 +/- 0.65% in hypertensive patients and 17.0 +/- 0.9% in control subjects). However, the relation between FENa and FELi was significantly different in normotensive subjects and hypertensive patients (P < .001), so that for a given increase in FENa a smaller increase in FELi was observed in hypertensive patients. In addition, the ratios of urinary lithium to sodium and urinary potassium to sodium were significantly reduced in hypertensive patients, suggesting an increased proximal reabsorption of sodium. Similar alterations in renal tubular sodium handling were observed in patients with white coat hypertension. These results suggest that an increased sodium reabsorption in the proximal tubule may contribute to the maintenance of hypertension and that white coat hypertension might represent a prehypertensive state.

This article has been cited by other articles:

				H. Mayan, S. Melnikov, I. Novikov, E. J. Holtzman, and Z. Farfel Familial Hyperkalemia and Hypertension: Pathogenetic Insights Based on Lithium Clearance J. Clin. Endocrinol. Metab., August 1, 2009; 94(8): 3010 - 3016. [Abstract] [Full Text] [PDF]

				E. M. Worcester, F. L. Coe, A. P. Evan, K. J. Bergsland, J. H. Parks, L. R. Willis, D. L. Clark, and D. L. Gillen Evidence for increased postprandial distal nephron calcium delivery in hypercalciuric stone-forming patients Am J Physiol Renal Physiol, November 1, 2008; 295(5): F1286 - F1294. [Abstract] [Full Text] [PDF]

				A. Chiolero, G. Wurzner, and M. Burnier Renal determinants of the salt sensitivity of blood pressure Nephrol. Dial. Transplant., March 1, 2001; 16(3): 452 - 458. [Full Text] [PDF]

				A. Chiolero, M. Maillard, J. Nussberger, H.-R. Brunner, and M. Burnier Proximal Sodium Reabsorption : An Independent Determinant of Blood Pressure Response to Salt Hypertension, October 1, 2000; 36(4): 631 - 637. [Abstract] [Full Text] [PDF]

				P. Owens, N. Atkins, and E. O'Brien Diagnosis of White Coat Hypertension by Ambulatory Blood Pressure Monitoring Hypertension, August 1, 1999; 34(2): 267 - 272. [Abstract] [Full Text] [PDF]

				P. Manunta, M. Burnier, M. D'Amico, L. Buzzi, M. Maillard, C. Barlassina, G. Lanella, D. Cusi, and G. Bianchi Adducin Polymorphism Affects Renal Proximal Tubule Reabsorption in Hypertension Hypertension, February 1, 1999; 33(2): 694 - 697. [Abstract] [Full Text] [PDF]

				P. Palatini, P. Mormino, M. Santonastaso, L. Mos, M. Dal Follo, G. Zanata, and A. C. Pessina Target-Organ Damage in Stage I Hypertensive Subjects With White Coat and Sustained Hypertension: Results From the HARVEST Study Hypertension, January 1, 1998; 31(1): 57 - 63. [Abstract] [Full Text]

				B. Grunfeld, M. Gimenez, M. Balzaretti, L. Rabinovich, M. Romo, and R. Simsolo Insulin Effect on Renal Sodium Reabsorption in Adolescent Offspring of Essential Hypertensive Parents Hypertension, December 1, 1995; 26(6): 1089 - 1092. [Abstract] [Full Text]

				M. Burnier, M. Hagman, J. Nussberger, J. Biollaz, C. Armagnac, R. Brouard, B. Waeber, and H. R. Brunner Short-term and Sustained Renal Effects of Angiotensin II Receptor Blockade in Healthy Subjects Hypertension, April 1, 1995; 25(4): 602 - 609. [Abstract] [Full Text]