Document Detail

Renal sodium handling in patients with untreated hypertension and white coat hypertension.
MedLine Citation:
PMID:  8144219     Owner:  NLM     Status:  MEDLINE    
Renal tubular sodium handling was investigated prospectively in 48 normotensive subjects, 53 untreated hypertensive patients, and 13 patients with white coat hypertension using endogenous trace lithium as a marker of proximal sodium reabsorption. A 12-hour daytime ambulatory blood pressure recording was performed in all patients to confirm the diagnosis of hypertension. Patients were included in the white coat hypertension group if their office blood pressure was above 160/90 mm Hg but the mean value of their 12-hour ambulatory recording was lower than 140/90 mm Hg. All participants were studied on their normal diet and ate salt freely. Fractional excretions of sodium (FENa), lithium (FELi), and potassium (FEK) were measured simultaneously before blood pressure recording. FENa was significantly higher in hypertensive patients (0.84 +/- 0.05%, P < .05) than in normotensive control subjects (0.60 +/- 0.06%), and FELi was comparable in the two groups (15.4 +/- 0.65% in hypertensive patients and 17.0 +/- 0.9% in control subjects). However, the relation between FENa and FELi was significantly different in normotensive subjects and hypertensive patients (P < .001), so that for a given increase in FENa a smaller increase in FELi was observed in hypertensive patients. In addition, the ratios of urinary lithium to sodium and urinary potassium to sodium were significantly reduced in hypertensive patients, suggesting an increased proximal reabsorption of sodium. Similar alterations in renal tubular sodium handling were observed in patients with white coat hypertension. These results suggest that an increased sodium reabsorption in the proximal tubule may contribute to the maintenance of hypertension and that white coat hypertension might represent a prehypertensive state.
M Burnier; J Biollaz; J L Magnin; M Bidlingmeyer; H R Brunner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hypertension     Volume:  23     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-05-02     Completed Date:  1994-05-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  496-502     Citation Subset:  IM    
Policlinique Médicale Universitaire, Division of Hypertension, Lausanne, Switzerland.
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MeSH Terms
Blood Pressure
Hypertension / etiology,  metabolism*,  psychology
Kidney Tubules / metabolism*
Lithium / metabolism,  urine
Middle Aged
Office Visits
Potassium / metabolism,  urine
Prospective Studies
Renin / blood
Sodium / metabolism*,  urine
Stress, Psychological / complications
Reg. No./Substance:
7439-93-2/Lithium; 7440-09-7/Potassium; 7440-23-5/Sodium; EC

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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