Urine Conductivity a New Marker for Adverse Circadian Blood Pressure Profile

A.V. Sokolova, D.O. Dragunov, G.P. Arutyunov, M.V. Kobyakov

Patients with abnormal renal tubulointersticial tissue (TIT) have been known to have a high risk of adverse blood pressure profile such as «non-dipper» and «night-peaker». In this regard it is of interest to search for new markers associated with changes in function of renal TIT. In hypertensive patients it is associated with impaired reabsorption of electrolytes, primarily with changes in natriuresis, and hence in blood pressure profile.
Aim. To establish relationship between changes in natriuresis, urine conductivity and 24h blood pressure profile in patients with arterial hypertension (AH) stage I.
Material and methods. The study was conducted at Moscow's health centers. The study included patients (n=375) with stage I AH. All patients were examined to determine salt intake, urine conductivity and natriuresis in a single portion of urine collected in the morning, afternoon and evening hours.
Results. There was the interrelation of the level of urine conductivity and natriuresis in a single portion of urine at different time intervals. Adverse 24h profiles of blood pressure were characterized by the increased urine conductivity in the evening, whereas 24h blood pressure profile with blood pressure drop at night, on the contrary, was characterized by lower urine conductivity.
Conclusion. Our study suggests that increased urine conductivity i n «evening» hours is predictive for an adverse blood pressure profile. This finding implies that patients with AH stage I and high «evening» urine conductivity (more than 40 mS/cm) need ambulatory blood pressure monitoring to identify adverse diurnal blood pressure profile («non-dipper», «night-peaker»).

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