Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results.

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  • Additional Information
    • Source:
      Publisher: Wolters Kluwer Health, Inc Country of Publication: Netherlands NLM ID: 8306882 Publication Model: Print Cited Medium: Internet ISSN: 1473-5598 (Electronic) Linking ISSN: 02636352 NLM ISO Abbreviation: J Hypertens Subsets: MEDLINE
    • Publication Information:
      Publication: [Alphen aan den Rijn, the Netherlands] : Wolters Kluwer Health, Inc.
      Original Publication: London ; New York : Gower Academic Pub., [1983-
    • Subject Terms:
    • Abstract:
      Objectives: To identify associations among the plasma renin concentration (PRC), plasma aldosterone and urinary sodium (Na)/potassium (K) ratio, and to integrate these variables into a nomogram with the aim of estimating the expected versus observed aldosterone concentration.
      Methods: We studied 40 healthy normotensive children (5-8 years old, 57.5% girls) who were born at term and were adequate for their gestational age. Following overnight fasting, the PRC and plasma aldosterone in blood samples were measured, and the Na/K ratio was calculated from a simultaneously obtained urinary spot sample. A mathematical function was defined with these three variables, and a nomogram was built that would return the expected aldosterone concentration from the obtained plasma renin and urinary Na/K ratio values.
      Results: The PRC (B =  5.9, P < 0.001) and urinary Na/K ratio (B = -98.1, P = 0.003) were significant independent predictors of plasma aldosterone. The correlation between the observed plasma aldosterone and the expected plasma aldosterone, as obtained from the nomogram, was r = 0.88, P < 0.001. The average difference between the observed and expected plasma aldosterone was -0.89, with a standard deviation of ±30%.
      Conclusion: The strong correlation between the urinary Na/K ratio, from urine samples taken at the same as the blood samples, and plasma renin and aldosterone concentrations allowed us to build a nomogram to predict aldosterone levels. This approach may be useful for evaluating the renin-angiotensin-aldosterone system (RAAS) in pediatric patients with hypertension and RAAS dysfunction.
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    • Accession Number:
      4964P6T9RB (Aldosterone)
      9NEZ333N27 (Sodium)
      EC 3.4.23.15 (Renin)
      RWP5GA015D (Potassium)
    • Publication Date:
      Date Created: 20191203 Date Completed: 20210329 Latest Revision: 20210329
    • Publication Date:
      20231215
    • Accession Number:
      10.1097/HJH.0000000000002324
    • Accession Number:
      31790052