The impact of daily sodium intake on posttransplant hypertension in kidney allograft recipients.
BACKGROUND
Posttransplant hypertension is a well-known risk factor for long-term allograft failure and mortality in kidney recipients. Although dietary sodium restriction is a widely recommended nonpharmacological measure for control of blood pressure (BP), no detailed investigation has been conducted regarding the impact of dietary sodium restriction on this condition.


METHODS
Thirty-two patients on antihypertensive treatment completed the study. They were randomly divided into two groups: controls (group 1) versus strict sodium diet (group 2; 80 to 100 mmol sodium daily). After randomization, 24-hour urine for sodium measurement, BP, and allograft functions were recorded at baseline and after 3 months. BP treatment was reevaluated at each visit throughout the study.


RESULTS
At baseline, there was no significant difference in age, sex, serum creatinine, systolic and diastolic BP, antihypertensive drugs, or 24-hour urinary sodium levels between the groups. After 3 months, daily urinary sodium excretion (from 190+/-75 to 106+/-48 mEq/d, P<.0001), systolic BP (from 146+/-21 to 116+/-11 mm Hg), and diastolic BP (from 89+/-8 to 72+/-10 mm Hg) had significantly decreased in group 2, while no significant changes were observed in group 1.


CONCLUSIONS
Low sodium intake in combination with antihypertensive treatment appears to efficiently control BP in kidney allograft recipients with hypertension. Twenty-four-hour urinary sodium excretion should be checked regularly in these patients as a useful marker to indicate whether the patient complies with low sodium intake.
Keven
K
K
Ankara University School of Medicine, Department of Nephrology, Ankara, Turkey. keven@medicine.ankara.edu.tr
Yalçin
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S
Canbakan
B
B
Kutlay
S
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Sengül
S
S
Erturk
S
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Erbay
B
B
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D004039:Diet, Sodium-Restricted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy / Q000517:prevention & control; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000652:urine; D012982:Sodium, Dietary / Q000009:adverse effects*
D000959:Antihypertensive Agents; D012982:Sodium, Dietary; D012964:Sodium; D003404:Creatinine