title: Urinary sodium excretion has positive correlation with activation of urinary renin angiotensin system and reactive oxygen species in hypertensive chronic kidney disease.
abstract: It is not well described the pathophysiology of renal injuries caused by a high salt intake in humans. The authors analyzed the relationship between the 24-hr urine sodium-to-creatinine ratio (24HUna/cr) and renal injury parameters such as urine angiotensinogen (uAGT/cr), monocyte chemoattractant peptide-1 (uMCP1/cr), and malondialdehyde-to-creatinine ratio (uMDA/cr) by using the data derived from 226 hypertensive chronic kidney disease patients. At baseline, the 24HUna/cr group or levels had a positive correlation with uAGT/cr and uMDA/cr adjusted for related factors (P<0.001 for each analysis). When we estimated uAGT/cr in the 24HUna/cr groups by ANCOVA, the uAGT/cr in patients with ≥200 mEq/g cr was higher than in patients with <100 mEq/g cr (708 [95% CI, 448-967] vs. 334 [95% CI, 184-483] pg/mg cr, P=0.014). Similarly, uMDA/cr was estimated as 0.17 (95% CI, 0.14-0.21) pM/mg cr in patients with <100 mEq/g cr and 0.27 (95% CI, 0.20-0.33) pM/mg cr in patients with ≥200 mEq/g cr (P=0.016). During the 16-week follow-up period, an increase in urinary sodium excretion predicted an increase in urinary angiotensinogen excretion. In conclusion, high salt intake increases renal renin-angiotensin-system (RAS) activation, primarily, and directly or indirectly affects the production of reactive oxygen species through renal RAS activation.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea.
authors.forename: Shin-Young
authors.initials: SY
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Dong Ki
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jung Hwan
authors.identifier: 0000-0002-8737-0084
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Chun Soo
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Research Institute of Salt and Health, Seoul, Korea. ; Seoul K-Clinic, Seoul, Korea.
authors.forename: Suhnggwon
authors.identifier: 0000-0001-6904-9126
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea.
authors.forename: Ho Jun
authors.identifier: 0000-0003-1185-2631
authors.initials: HJ
authors.lastname: Chin
mesh_terms: D000328:Adult; D000368:Aged; D000808:Angiotensinogen / Q000652:urine; D018932:Chemokine CCL2 / Q000652:urine; D003401:Creatine / Q000652:urine; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008315:Malondialdehyde / Q000652:urine; D008875:Middle Aged; D017382:Reactive Oxygen Species / Q000378:metabolism*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000473:pathology*; D012084:Renin-Angiotensin System / Q000502:physiology*; D012982:Sodium, Dietary / Q000652:urine*; D059349:Urine Specimen Collection
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D017382:Reactive Oxygen Species; D012982:Sodium, Dietary; D000808:Angiotensinogen; D008315:Malondialdehyde; D003401:Creatine
keywords: Angiotensinogen; Chronic Renal Insufficiency; Renin; Sodium Chloride