Abstract:
BACKGROUND:Experimental evidence suggests that hyperosmolality may be a causative factor in the development of both salt-sensitive hypertension and chronic kidney disease (CKD). There are no population-wide studies in young persons to assess the relationships among these factors. OBJECTIVE:To determine the association of serum osmolality and serum sodium with high systolic blood pressure (SBP) and decreased estimated glomerular filtration rate (eGFR) among a nationally representative population of adolescents. METHOD:Relevant data among participants ages 12-14 were obtained from the National Health and Nutrition Examination Survey cycles 1999-2012. Serum osmolality was calculated using the Worthley equation. eGFR was calculated using the Counahan-Barratt equation, and values < 90 mL/min/1.73 m2 were considered decreased. High SBP was defined as SBP ≥95th percentile for age, height, and sex. RESULTS:A total of 4,168 adolescents were analyzed (representative population: 10,464,592). Adolescents with serum osmolality ≥290 mOsm/kg and/or serum sodium ≥143 mmol/L had increased odds for both high SBP (serum osmolality ≥290 mOsm/kg: OR 2.04; 95% CI 1.03-4.02; sodium ≥143 mmol/L: OR 4.36; 95% CI 1.58-12.04) and decreased eGFR (serum osmolality ≥290 mOsm/kg: OR 1.61; 95% CI 1.18-2.21; sodium ≥143 mmol/L: OR 3.27; 95% CI 1.77-6.03) when compared to participants with values below these thresholds. These thresholds remained significant even after multivariable adjustment. CONCLUSION:Among adolescents in a nationally representative survey, hypernatremia and hyperosmolality were associated with high SBP and decreased eGFR. These findings may support the hypothesis that an imbalance of salt and water contribute to hypertension and CKD.
journal_name
Nephronjournal_title
Nephronauthors
Chmielewski J,Khalsa DD,Carmody JBdoi
10.1159/000497780subject
Has Abstractpub_date
2019-01-01 00:00:00pages
216-226issue
3eissn
1660-8151issn
2235-3186pii
000497780journal_volume
142pub_type
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