Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results

Martinez-Aguayo, Alejandro G.; Campino, Carmen; Rodriguez-Fernandez, Maria; Poggi, Helena; D’apremont, Ivonne; Moore, Rosario; Garcia, Hernan; Solari, Sandra; Allende, Fidel; Peredo, Soledad; Trincado, Claudia; Carvajal, Cristian; Arancibia, Monica; Ossa, Jose Tomas; Sifaqui, Sofia; et. al.

Abstract

Objectives: To identify associations among the plasma renin concentration (PRC), plasma aldosterone and urinary sodium (Na)/potassium (K) ratio, and to integrate these variables into a nomogram with the aim of estimating the expected versus observed aldosterone concentration. Methods: We studied 40 healthy normotensive children (5-8 years old, 57.5% girls) who were born at term and were adequate for their gestational age. Following overnight fasting, the PRC and plasma aldosterone in blood samples were measured, and the Na/K ratio was calculated from a simultaneously obtained urinary spot sample. A mathematical function was defined with these three variables, and a nomogram was built that would return the expected aldosterone concentration from the obtained plasma renin and urinary Na/K ratio values. Results: The PRC (B = 5.9, P < 0.001) and urinary Na/K ratio (B = -98.1, P = 0.003) were significant independent predictors of plasma aldosterone. The correlation between the observed plasma aldosterone and the expected plasma aldosterone, as obtained from the nomogram, was r = 0.88, P < 0.001. The average difference between the observed and expected plasma aldosterone was -0.89, with a standard deviation of +/- 30%. Conclusion: The strong correlation between the urinary Na/K ratio, from urine samples taken at the same as the blood samples, and plasma renin and aldosterone concentrations allowed us to build a nomogram to predict aldosterone levels. This approach may be useful for evaluating the renin-angiotensin-aldosterone system (RAAS) in pediatric patients with hypertension and RAAS dysfunction.

Más información

Título según WOS: Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results
Título según SCOPUS: Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results
Título de la Revista: JOURNAL OF HYPERTENSION
Volumen: 38
Número: 4
Editorial: LIPPINCOTT WILLIAMS & WILKINS
Fecha de publicación: 2020
Página de inicio: 671
Página final: 678
Idioma: English
DOI:

10.1097/HJH.0000000000002324

Notas: ISI, SCOPUS