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Abstract: PO2543

Serum Aldosterone and Urine Electrolytes Dynamics in Response to DASH Intervention: An Inpatient Mechanistic Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Bielopolski, Dana, The Rockefeller University, New York, New York, United States
  • Qureshi, Adam, The Rockefeller University, New York, New York, United States
  • Ronning, Andrea, The Rockefeller University, New York, New York, United States
  • Tobin, Jonathan N., The Rockefeller University, New York, New York, United States
  • Kost, Rhonda, The Rockefeller University, New York, New York, United States
Background

The Dietary Approaches to Stop Hypertension (“DASH diet”) is a proven intervention to treat hypertension and is as effective as one antihypertensive drug. Despite years of research the precise understanding of its mechanism of action is lacking. We designed a translational trial to elucidate the biological pathway leading from nutritional change, through hormonal response, variations in urine electrolytes to blood pressure (BP) reduction.

Methods

A single center interventional trial. Stage 1 hypertensive otherwise healthy volunteers were admitted for 14-days, transitioning from American style diet to the DASH diet. Data were collected daily for vital signs, blood (chemistry) and urine (electrolytes). On days 1 and 10, participants completed 24-hour ambulatory blood pressure monitoring (ABPM) and 24-hour urine collections.

Results

9volunteers completed the protocol (7 men, 8 Black participants). Serum Aldosterone increased from day 0 (mean 8.3, range 2.8-18.9) to day 5 (mean 17.8, range 10.2-27.2) after intervention, and decreased on day 11 (mean 11.5, range 4.8-18.2) despite continuous exposure to the diet (p-value= 0.001). Urine ([Na]/[K]) electrolytes ratio (Picture 1) decreased from a mean of 3.5 before intervention on day 1 to 1.16 on day 4. BP reductions on 24-hour ABPM from day 1 to 10 were observed for the entire period, and during both sleep and awake recordings.

Conclusion

Shifting from a high-sodium/low-potassium diet to the opposite leads to serial physiological changes that are governed by Aldosterone and result in blood pressure reduction. Clinicians should follow urine electrolytes ratio to assess adherence to nutritional recommendations.

Daily Mean Urine Electrolytes Ratio.

Funding

  • Other NIH Support