Role of dietary salt intake in posttransplant hypertension with tacrolimus-based immunosuppression.
Dietary salt is an important contributor to hypertension in the general population. While its role in cyclosporine-induced hypertension is minimal, its role in tacrolimus-based immunosuppression has not been defined. We measured the 24-hour urine sodium excretion as an estimate of intake in a group of stable renal transplant recipients on tacrolimus (N = 143) who had serum creatinine fluctuations <20% during the preceding 3 months. Average clinic-measured blood pressure (BP) from before and after the 24-hour urine collection was computed. Patients with recent changes in antihypertensive medications were excluded. Average systolic BP was 126 +/- 14 and diastolic BP 76 +/- 7 mm Hg. Urine sodium was 162.6 +/- 70 mmol/d (range 50 to 351), and the sodium/creatinine ratio was 15.4 +/- 6.4. There was no correlation between urine sodium excretion and either systolic or diastolic BP (R = 0.07 and R = 0.05, P = NS) or the sodium/creatinine and systolic/diastolic BP (R = 0.13, R = 0.11, P = NS). By multiple linear regression only weight and urine protein were independently associated with both systolic BP (P < .0001 for each) and diastolic BP (P < .05 for each). In conclusion, there is no appreciable influence of dietary salt intake on BP under tacrolimus-based immunosuppression. Restricting dietary salt intake in these patients cannot be recommended at the current time.
Prasad
G V R
GV
University of Toronto, Renal Transplant Program, St. Michael's Hospital, Toronto, Ontario, Canada. prasadr@smh.toronto.on.ca
Huang
M
M
Nash
M M
MM
Zaltzman
J S
JS
D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology*; D011183:Postoperative Complications / Q000503:physiopathology*; D011507:Proteinuria; D012964:Sodium / Q000652:urine*; D017673:Sodium Chloride, Dietary / Q000494:pharmacology*; D016559:Tacrolimus / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D017673:Sodium Chloride, Dietary; D012964:Sodium; D016559:Tacrolimus