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Circadian rhythm of urinary potassium excretion in patients with CKD

Toshiyuki Miura1, Michio Fukuda, Takehiro Naito

  • 1Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan.

Clinical Nephrology
|August 10, 2012
PubMed

Insights

The circadian rhythm of urinary potassium excretion in chronic kidney disease (CKD) patients is linked to sodium excretion, not renal function or blood pressure. This finding highlights a new aspect of electrolyte balance in CKD.

Area of Science:

  • Nephrology
  • Chronobiology
  • Physiology

Background:

  • Previous research indicated impaired circadian rhythms of blood pressure and urinary sodium excretion in chronic kidney disease (CKD) patients.
  • The circadian rhythm of urinary potassium excretion in relation to renal dysfunction remained unstudied.

Purpose of the Study:

  • To investigate the relationship between the circadian rhythm of urinary potassium excretion and renal function in CKD patients.
  • To explore the determinants of the circadian rhythm of urinary potassium excretion, including renal function, blood pressure, and urinary sodium excretion.

Main Methods:

  • Evaluated daytime and nighttime urinary excretion rates of sodium (UNaV) and potassium (UKV) in 83 CKD subjects.
  • Estimated circadian rhythms using night/day ratios for BP, UNaV, and UKV.
  • Employed multiple regression analysis to identify independent predictors of UKV circadian rhythm.

Main Results:

  • Night/day ratios of both UNaV and UKV increased with deteriorating renal function.
  • The night/day ratio of UKV was positively correlated with the night/day ratio of UNaV (r = 0.60, p < 0.0001).
  • Multiple regression analysis indicated that the night/day ratio of UKV was independently determined by the night/day ratio of UNaV (r = -0.55, p < 0.0001), not renal function or BP.

Conclusions:

  • Circadian rhythm of natriuresis is influenced by renal function and blood pressure.
  • Circadian rhythm of urinary potassium excretion is primarily determined by urinary sodium excretion, independent of renal function or blood pressure in CKD.
Abstract

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