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Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
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Updated: Aug 14, 2025

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
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Effect of Orthostatic Hypotension on Kidney Function.

Jin Hee Na1, Sung Rok Kim1, Yu-Ji Lee1

  • 1Division of Nephrology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.

Nephron
|January 17, 2023
PubMed
Summary

Orthostatic hypotension (OH) is linked to faster kidney function decline. This study found OH patients experienced a greater decrease in estimated glomerular filtration rate (eGFR) over 12 years.

Keywords:
Blood pressureGeneral populationKidney functionOrthostatic hypotension

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Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • The relationship between orthostatic hypotension (OH) and long-term kidney function changes in the general population remains unclear.
  • Orthostatic hypotension is a condition characterized by a significant drop in blood pressure upon standing.

Purpose of the Study:

  • To investigate the association between classic orthostatic hypotension and longitudinal changes in kidney function.
  • To assess the impact of OH on the decline of estimated glomerular filtration rate (eGFR) over a 12-year period.

Main Methods:

  • A population-based cohort study utilizing data from the Korean Genome and Epidemiology Study (KoGES).
  • Classic OH defined as a systolic blood pressure drop ≥20 mm Hg and/or diastolic blood pressure drop ≥10 mm Hg within 2 minutes of standing.
  • Kidney function change measured by the difference in eGFR from baseline to 12-year follow-up.

Main Results:

  • The study included 5,905 participants; 4.5% had classic OH.
  • Participants with classic OH showed a significantly greater decline in eGFR over 12 years (beta = -1.74, 95% CI: -3.07 to -0.40).
  • Classic OH was associated with a 27% increased risk of a 30% decline in kidney function (HR = 1.27, 95% CI: 1.07 to 1.49).

Conclusions:

  • Classic orthostatic hypotension is associated with accelerated long-term decline in kidney function.
  • Findings suggest OH is a risk factor for kidney function deterioration in the general population.