gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Salt Consumption and 24-h Blood Pressure Profiling in Chronic Renal Failure

Salzkonsum und Hypertonieklassifikation durch 24-h Blutdruckmessung bei chronischer Niereninsuffizienz

Meeting Abstract (Hypertonie 2003)

Suche in Medline nach

  • presenting/speaker S. Jerassek - Klinik für Innere Medizin III, FSU (Jena, D)
  • J. Bohlender - Klinik für Innere Medizin III, FSU (Jena, D)
  • G. Stein - Klinik für Innere Medizin III, FSU (Jena, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochP8

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2003/03hoch108.shtml

Veröffentlicht: 11. November 2004

© 2004 Jerassek et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Aim

Patients with chronic renal failure lack capacity to excrete osmolytes, easily retain fluids and react with hypertension upon a salt load. The value of 24h ambulatory blood pressure measurement (ABPM) compared with office BP to correctly detect and classify hypertension in this context remains unclear.

Methods

In a retrospective survey, we analyzed 142 consecutive and otherwise unselected out-patients with chronic renal failure and 24h ABPM attending our nephrology department. Serum creatinine (CREA), daily Na, K and Ca excretion, body mass index, urinary volume and serum electrolytes were analyzed. Patients had been instructed to comply with a reduced salt diet of <6 g/d. Antihypertensive medication was adjusted to a BP goal <130/90 mm Hg.

Results

Mean age was 50 13 y, mean CREA was 213 183 mol/L, 35% were female, 19,7% diabetics, 54% had chronic glomerulonephritis, all were on antihypertensive medication and 62% had >2 such drugs. Mean daily excretion of Na+ , K+ and Ca2+ was 210, 65 and 2.8 mmol, respectively. Mean office BP was 140/81 mm Hg and not different from day ABP, without a sex difference. Men ate about 3 g/d more salt than women. Daily urinary volume (2518 690 ml/d) correlated with 24h Na excretion (r=0.37, p<0.01) but not with CREA. There was no difference in Na excretion, urinary volume and serum electrolyte concentrations between ABPM-dippers (12%) and non-dippers or when patients were classified according to WHO hypertension grades (p=NS). CREA correlated with 24h systolic ABP values (r=0.31, p<0.05) but not with office BP. ABPM reclassified hypertension correctly in about 1/5 of the patients depending on salt intake compared with office BP.

Conclusion

Average daily salt consumption was 2-3 times above the recommended limit, did not differ between hypertension grades and imposed an avoidable osmotic and volume load in patients with chronic renal disease and hypertension. ABPM helped reduce misclassifications of hypertension.