Abstract: PO2011
Correlation Between Kidney Sodium and Potassium Handling and the Renin-Angiotensin-Aldosterone System in Children with Hypertension
Session Information
- Pediatric Nephrology: Genetics, Kidney Stones, Quality Improvement, and Case Reports
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1700 Pediatric Nephrology
Authors
- Perrin, Ella C., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- South, Andrew M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
Background
Urine sodium and potassium concentrations are used as surrogate markers for dietary sodium and potassium consumption in adults with hypertension, but their association with components of the renin-angiotensin-aldosterone system (RAAS) is incompletely characterized. Some individuals with hypertension may have an abnormal RAAS response to dietary sodium and potassium intake, though this is incompletely described. Our objective was to investigate if plasma renin activity and serum aldosterone are associated with urine sodium and potassium in youth with hypertensive disorders.
Methods
This pilot study was a cross-sectional analysis of baseline data from 44 youth being evaluated for hypertensive disorders in a Hypertension Clinic. We recorded urine sodium and potassium normalized to urine creatinine, plasma renin activity, and serum aldosterone values and calculated the sodium/potassium (UNaK) and aldosterone/renin ratios. We used multivariable generalized linear models to estimate the associations of renin and aldosterone with urine sodium and potassium.
Results
Our cohort was diverse (37% non-Hispanic Black, 14% Hispanic), 66% were male, and median age was 15.3 years; 9% had a secondary etiology and 77% had obesity. Aldosterone was associated inversely with urine sodium/creatinine (β: -0.34, 95% CI -0.62 to -0.06) and UNaK (β: -0.09, 95% CI -0.16 to -0.03), adjusted for estimated glomerular filtration rate and serum potassium.
Conclusion
Higher serum aldosterone levels, but not plasma renin activity, were associated with lower urine sodium and UNaK at baseline in youth referred for hypertensive disorders. Further characterization of the RAAS could help define hypertension phenotypes and guide treatment.
Association between serum aldosterone and urine sodium/potassium ratio. Regression line with 95% confidence limits of the mean predicted values shown; p<0.05 by unadjusted and adjusted generalized linear regression.
Funding
- NIDDK Support