This Article Full Text Full Text (PDF) All Versions of this Article: 51/4/827    most recent HYPERTENSIONAHA.108.110213v1 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 Kimura, G. Search for Related Content PubMed PubMed Citation Articles by Kimura, G. Related Collections Clinical Studies Related Article

(Hypertension. 2008;51:827.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Kidney and Circadian Blood Pressure Rhythm

Genjiro Kimura

From the Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Association between nondipper pattern of circadian rhythm of blood pressure (BP) and impaired renal capacity to excrete sodium into urine was confirmed by Bankir et al¹ in this issue of Hypertension based on a large number of subjects. Although this association has been observed in small studies,^2,3 their study¹ is the first to show it in a large-scale setting, and, therefore, is highly welcomed.

Because there is a tight link between kidney and hypertension, renal dysfunction causes hypertension, whereas hypertension accelerates renal damage. It is well appreciated that the kidneys play an important role in the long-term regulation of BP. Usually it takes almost 1 week for kidneys to achieve a new steady-state balance of sodium, when sodium intake is altered. Therefore, renal participation in the short-term BP regulation, such as circadian rhythm, has been overlooked. However, the findings of Bankir et al¹ strongly suggest that nocturnal hypertension and nondipper pattern of circadian BP rhythm are because of impaired renal capacity to excrete sodium, and circadian BP rhythm is at least in part regulated by kidneys.

	Circadian Rhythm of BP and Sodium Sensitivity

 
Sodium sensitivity of BP is also determined by renal capacity to excrete sodium and is regulated by glomerulotubular balance between glomerular ultrafiltration capability and rate of tubular sodium reabsorption.⁴ Thus, sodium sensitivity is increased in chronic kidney disease (CKD) where glomerular filtration rate (GFR) is reduced and also in disorders with enhanced tubular sodium reabsorption, including primary aldosteronism, diabetes mellitus, and metabolic syndrome, where GFR is augmented. When sodium sensitivity is increased, glomerular capillary . . . [Full Text of this Article]

Related Article:

Nighttime Blood Pressure and Nocturnal Dipping Are Associated With Daytime Urinary Sodium Excretion in African Subjects

Lise Bankir, Murielle Bochud, Marc Maillard, Pascal Bovet, Anne Gabriel, and Michel Burnier
Hypertension 2008 51: 891-898. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				R. D. Rudic and D. J. Fulton Pressed for time: the circadian clock and hypertension J Appl Physiol, October 1, 2009; 107(4): 1328 - 1338. [Abstract] [Full Text] [PDF]

				M. Bursztyn and I. Z. Ben-Dov Diabetes Mellitus and 24-Hour Ambulatory Blood Pressure Monitoring: Broadening Horizons of Risk Assessment Hypertension, February 1, 2009; 53(2): 110 - 111. [Full Text] [PDF]

				E. Ritz Nephrology Potpourri Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1253 - 1259. [Full Text] [PDF]