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Abstract: PO1760

Preterm Birth and Its Association with Altered Renal Sodium Handling in Response to Mental Stress in Young Adults

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Tully, Nicholas William, 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

Early-life programming events such as preterm birth and very low birth weight (VLBW; <1500 g) contribute to later hypertension development, but the underlying mechanisms are unknown. Experimental data suggest that altered pressure natriuresis and renal sodium handling may be important contributing mechanisms. Adults with primary hypertension exhibit blunted pressure natriuresis in response to sympathetic arousal, but this has not been described in adults born preterm. We investigated renal sodium excretion relative to the change in blood pressure (BP) in response to stress in a cohort of young adults born preterm with VLBW. We hypothesized that young adults born preterm will have a blunted pressure natriuresis response to mental stress compared to those born term with normal birth weight.

Methods

In this long-term prospective cohort of 161 individuals, 129 (80%) born preterm with VLBW and 32 (20%) term-born controls, we measured spot urine sodium/creatinine before and after a 30-min mental stress test and non-invasive continuous BP every 2 min during the stress test. We defined our outcome, pressure natriuresis, as the change in sodium excretion relative to the change in mean arterial pressure (MAP) before and after the stress test with a blunted response being < 0 mg/dL per mmHg. We used generalized linear models to estimate the association between prematurity and the outcome.

Results

The mean age of study participants was 19.8 (SD 0.9) of whom 56% were female. Among those born preterm, median change in sodium excretion relative to change in MAP was 0.022 mg/dL per mmHg [IQR -0.021, 0.12], while the change in term-born counterparts was 0.04 mg/dL per mmHg [-0.005, 0.184]. On unadjusted analyses, the preterm/term difference in pressure natriuresis was B=0.068 mg/dL per mmHg (-0.092 to 0.228), and the relative risk of blunted pressure natriuresis was 1.3 (0.71 to 2.36).

Conclusion

We observed no statistically significant difference in pressure natriuresis response in adults born preterm with VLBW when compared to those born term. Ongoing analyses include investigating other measures of pressure natriuresis in adjusted multivariable models.

Funding

  • NIDDK Support