Changes in the renin-angiotensin-aldosterone system in response to dietary salt intake in normal and hypertensive pregnancy. A randomized trial.
It was hypothesized that primary renal sodium retention blunted the reactivity of the renin-angiotensin-aldosterone system to changes in salt intake in preeclampsia (PE). A randomized, cross-over, double-blinded, dietary intervention design was used to measure the effects of salt tablets or placebo during low-salt diet in PE patients (n = 7), healthy pregnant women (n = 15), and nonpregnant women (n = 13). High-salt intake decreased renin and angiotensin II concentrations significantly in healthy pregnant women (P < .03) and in nonpregnant women (P < .001), but not in PE (P = .58), while decreases in aldosterone and increases in brain natriuretic peptid (BNP) were similar in the groups. In PE patients, uterine and umbilical artery indices were not adversely changed during low-salt diet. Creatinine clearance was significantly lower in PE with no change by salt intake. PE patients displayed alterations of plasma renin and angiotensin II in response to changes in dietary salt intake compatible with a primary increase in renal sodium reabsorption in hypertensive pregnancies.
Department of Gynecology and Obstetrics, Institute of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus N, Denmark. Electronic address: lihn@clin.au.dk.
Lise H
LH
Nielsen
Department of Gynecology and Obstetrics, Institute of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus N, Denmark.
Per
P
Ovesen
Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.
Mie R
MR
Hansen
Department of Pediatrics, Institute of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus N, Denmark.
Steven
S
Brantlov
Department of Nephrology, Aarhus University Hospital Skejby, Aarhus N, Denmark.
Bente
B
Jespersen
Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.
Peter
P
Bie
Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.
Boye L
BL
Jensen
D000328:Adult; D000450:Aldosterone / Q000097:blood / Q000378:metabolism*; D000804:Angiotensin II / Q000097:blood; D001795:Blood Pressure Determination; D003404:Creatinine / Q000097:blood; D004039:Diet, Sodium-Restricted; D004311:Double-Blind Method; D053503:Epithelial Sodium Channels / Q000187:drug effects*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000178:diet therapy* / Q000652:urine; D011247:Pregnancy; D065608:Renal Reabsorption; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects*; D017673:Sodium Chloride, Dietary / Q000009:adverse effects* / Q000378:metabolism; D055988:Uterine Artery / Q000502:physiology
D053503:Epithelial Sodium Channels; D017673:Sodium Chloride, Dietary; D000804:Angiotensin II; D000450:Aldosterone; D003404:Creatinine; D012083:Renin
Hypertension; plasmin; proteinuria