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Published on: September 22, 2011
Heterogeneous patterns of sodium excretion during sodium restriction in essential hypertensive patients
M M Krekels1, A J Houben, A T Lavrijssen
1Department of Medicine, University Hospital Maastricht, The Netherlands.
Objective:
To study the sodium excretory pattern by which sodium balance is reached.
Methods:
Ninety untreated essential hypertensives with a median age of 47 (range: 18-70 years) were admitted to a metabolic ward for 7 days and put on a sodium diet of 55 mmol/day. During these 7 days urinary excretions of sodium, potassium and creatinine were determined daily along with mean arterial pressure (MAP) and weight.
Results:
Changes in urinary sodium excretion were not uniform, but according to the pattern of attaining sodium balance, subjects could be divided into four groups. Group 1 (n = 31) gradually reached sodium balance, whereas group 2 (n = 10) showed an abrupt fall in sodium excretion on the third day and an extremely fluctuating sodium excretion thereafter. Group 3 (n = 32) reached sodium balance on day four, but displayed a rise in sodium excretion during the following days and group 4 (n = 17) attained sodium balance only very slowly or not at all. Compared to the other groups, group 4 lost more sodium and at the same time displayed a greater fall in blood pressure.
Conclusions:
Our data suggest that there may be at least four different patterns by which sodium balance can be reached following a reduction in sodium intake. The determinants of these responses remain, however, elusive.
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