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Relationships of hyperchloremia with hypertension and proteinuria in patients with chronic kidney disease

Akira Takahashi1, Kazuya Maeda2,3, Kensuke Sasaki1

  • 1Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi Minami-ward, Hiroshima, 734-8551, Japan.

Clinical and Experimental Nephrology
|May 7, 2022
PubMed

Insights

High chloride levels (hyperchloremia) are linked to high blood pressure and protein in urine for chronic kidney disease (CKD) patients. Reducing serum chloride improved these conditions, suggesting chloride management is key for CKD treatment.

Area of Science:

  • Nephrology and Clinical Biochemistry
  • Cardiovascular Health and Renal Disease

Background:

  • Previous studies suggest chloride (Cl) involvement in hypertension and proteinuria development.
  • Hyperchloremia's specific association with hypertension and proteinuria in chronic kidney disease (CKD) requires further investigation.
  • Understanding the link between serum Cl reduction and improvements in hypertension/proteinuria is crucial for CKD management.

Purpose of the Study:

  • To investigate the association between hyperchloremia and hypertension or proteinuria in CKD patients.
  • To determine if reducing serum Cl concentration during CKD treatment correlates with improvements in hypertension and/or proteinuria.

Main Methods:

  • Retrospective observational study of 51 new or referred CKD patients with hyperchloremia, proteinuria, renal dysfunction, and hypertension.
  • Exclusion criteria included medication for metabolic acidosis or prior dialysis.
  • Measurements included blood pressure (BP), serum sodium (Na) and chloride (Cl) concentrations, and urinary protein (UP) at baseline and after 1 month of treatment.

Main Results:

  • Serum Cl concentration independently correlated with systolic BP (sBP) and UP at baseline (P=0.022 and P=0.033).
  • After 1 month of CKD treatment, significant reductions in serum Na, Cl, sBP, and UP were observed.
  • The change in sBP (ΔsBP) was independently associated with the change in serum Cl (ΔCl) (P=0.029), but not with ΔNa.

Conclusions:

  • Hyperchloremia is an independent predictor of hypertension and proteinuria in patients with CKD.
  • Reduction in serum chloride concentration during CKD treatment is associated with improvements in blood pressure and proteinuria.
  • These findings highlight the potential therapeutic role of chloride management in CKD patients.
Abstract

Keywords:
ChlorideChronic kidney diseaseHyperchloremiaHypertensionProteinuriaSodium

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