The role of dietary cations in the blood pressure of renal transplant recipients (original) (raw)
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Sodium intake and blood pressure in renal transplant recipients
Nephrology Dialysis Transplantation, 2012
Background. Hypertension is common among renal transplant recipients (RTR) and a risk factor for graft failure and mortality. Sodium intake is a well-established determinant of blood pressure (BP) in the general population. However, data in RTR are limited. International guidelines recommend a maximum daily sodium intake of 70 mmol. We investigated sodium intake in RTR as compared to healthy controls and its association with BP. Methods. We included 660 RTR (age 53 ± 13 years, 58% male) and 201 healthy controls (age 54 ± 11 years, 46% male). Sodium intake was assessed from 24-h urine collections. The morning after completion of urine collection, BP was measured according to a strict protocol. Results. Urinary sodium excretion was 156 ± 62 mmol/ 24 h in RTR and 195 ± 75 in controls (difference: P < 0.001), and 95% of RTR had a urinary sodium excretion >70 mmol/24 h. Systolic BP (SBP) and diastolic BP (DBP) were 136 ± 18 and 82 ± 11 mmHg, respectively. Sodium intake was positively associated with SBP (β = 0.042 mmHg/mmol/24 h, P = 0.002) and DBP (β = 0.023 mmHg/mmol/24 h, P = 0.007), independent of potential confounders. Conclusions. Although RTR had a lower sodium intake than healthy controls, their intake still exceeded current guidelines. Reduction of sodium intake to recommended amounts could reduce SBP by 4-5 mmHg. Better control of sodium intake may help to prevent graft failure and mortality due to hypertension among RTR.
Nephrology Dialysis Transplantation, 2020
Background and Aims Cardiovascular morbidity and mortality are increased in kidney transplant patients. High blood pressure (BP) contributes significantly to this risk and is associated with shortened allograft survival. Dietary salt reduction is widely recommended as a strategy to lower BP in the general population and in chronic kidney disease. Due to a lack of evidence there is currently no consensus on dietary salt restriction in kidney transplant patients. The primary aim of the study was to examine the impact of reduced dietary salt intake on BP in kidney transplant patients. Method Sixty stable kidney transplant patients, ≥ 6-months post-transplantation, with BP ≥120/80 mmHg, and sodium intake ≥80 mmol/24hrs, were randomised in this parallel-designed study to receive either a regular-salt diet (target 150 mmol/24hr) or a low-salt diet (target 80 mmol/24hr) for 8-weeks. The primary outcome measure was systolic and diastolic BP. Secondary outcome measures included 24-hour ambul...
Dietary protein, blood pressure and renal function in renal transplant recipients
British Journal of Nutrition, 2012
Hypertension is highly prevalent among renal transplant recipients (RTR) and a risk factor for graft failure and cardiovascular events. Protein intake has been claimed to affect blood pressure (BP) in the general population and may affect renal function. We examined the association of dietary protein with BP and renal function in RTR. We included 625 RTR (age 53 (sd13) years; 57 % male). Protein intake was assessed with a FFQ, differentiating between animal and plant protein. BP was measured according to a strict protocol. Creatinine clearance and albuminuria were measured as renal parameters. Protein intake was 83 (sd12) g/d, of which 63 % derived from animal sources. BP was 136 (sd17) mmHg systolic (SBP) and 83 (sd11) mmHg diastolic (DBP). Creatinine clearance was 66 (sd26) ml/min; albuminuria 41 (10–178) mg/24 h. An inverse, though statistically insignificant, association was found between the total protein intake and both SBP (β = − 2·22 mmHg persd,P= 0·07) and DBP (β = − 0·48 m...
Nutrients
Several dietary indices assess the impacts of the Dietary Approaches to Stop Hypertension (DASH) diet on health outcomes. We explored DASH adherence and renal function among 85 Taiwanese renal transplant recipients (RTRs) in a cross-sectional study. Data collection included demographics, routine laboratory data, and 3-day dietary records. Three separate DASH indices, that defined by Camões (based on nine nutrients), that defined by Fung (using seven food groups and sodium), and that modified by Fung (as above but separated for men and women) were used. Renal function was ascertained through the estimated glomerular filtration rate (eGFR) from patients’ medical records. Participants’ mean age was 49.7 ± 12.6 years and eGFR was 54.71 ± 21.48 mL/min/1.73 m2. The three established DASH diet indices displayed significant correlations (r = 0.50–0.91) and indicated the nutritional adequacy of the diet. Multiple linear regressions indicated a significant positive association between higher ...
Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia, 2021
INTRODUCTION AND OBJECTIVES Prevalence of hypertension increases as glomerular filtration rate (GFR) declines. Renalase metabolizes catecholamines and have an important role in blood pressure (BP) regulation. The purpose of the study was to evaluate the effect of kidney transplantation on renalase levels and BP in kidney donors and recipients. MATERIALS AND METHODS Twenty kidney transplant recipients and their donors were included in the study. Serum renalase levels and ambulatory BP values were measured in both donors and recipients before and after transplantation. Factor associated with change in renalase and BP levels were also evaluated. RESULTS In donors; mean GFR and hemoglobin levels decreased while night-time systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels and serum renalase levels increased simultaneously after nephrectomy. Day-time SBP and DBP levels did not changed and the night/day ratio of mean arterial pressure (MAP) increased significantly. In...
Dietary Nutrients and Cardiovascular Risk Factors among Renal Transplant Recipients
International Journal of Environmental Research and Public Health, 2021
Cardiovascular disease (CVD) is the leading cause of mortality in post-renal transplant recipients (RTRs). Adequate nutrient intake is a protective factor for CVD. We examined the associations of macronutrients and micronutrients with traditional and nontraditional CVD risk factors. Conducted from September 2016 to June 2018, this cross-sectional study included 106 RTRs aged ≥18 years with a functioning allograft. Dietary intake data from 3-day dietary records were collected. Nutrient intake adequacy was defined using various instruments, including the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. CVD risk factors were defined according to the K/DOQI guidelines. Bivariate and multivariate logistic regression models were used to analyze the associations. CVD risk was present in all patients; the lowest proportions of adequate intake were 2.8% for dietary fiber and 0.9% for calcium. Adequate nutrient intake was associated with a lower likel...
Blood Pressure Treatment in Kidney Transplant Recipients—Can We Improve?
Transplantation Direct, 2021
K idney transplantation (KTx) is the preferred treatment for patients with kidney failure, leading to increased patient survival and improved quality of life compared with dialysis. 1-5 Despite successful transplantation, cardiovascular (CV) disease remains the leading causes of increased mortality and the main nonimmunological reason for graft loss. 6,7 Posttransplant hypertension is common with a reported prevalence of 50%-90%, 8-10 and an important risk factor for CV complications and reduced graft function. 11,12 Observational studies by Opelz and Döhler 13 reported a stepwise improvement in both graft and patient survival associated with lower blood pressure (BP). A similar tendency was reported for systolic BP by Carpenter et al 14 who assessed the possible association between BP and CV disease in a post hoc analysis of participants in the Folic Acid for Vascular Outcome Reduction In Transplantation trial. They found that each 20-mm Hg increase in systolic BP was associated with a 32% increase in the risk of CV events. A consensus on a specific BP target for KTx recipients has, however, not been clearly specified. 15,16 Based on the available literature, the Norwegian Renal Registry (NRR) has adapted the Kidney Disease Improving Global Outcomes (KDIGO)
Optimizing hypertension management in renal transplantation: a call to action
Nephrology Dialysis Transplantation, 2017
on behalf of the European Renal and Cardiovascular Medicine (EURECA-m) and the transplant DESCARTES working group of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA), the Working Group 'Hypertension and Kidney' of the European Society of Hypertension (ESH), the EKITA committee of the European Society of Organ Transplantation (ESOT) and the FCRIN INI-CRCT Cardiovascular and