Acta clinica Croatica, Vol. 62. No. 2, 2023.
Original scientific paper
https://doi.org/10.20471/acc.2023.62.02.09
Uromodulin – a Link between Sodium Excretion and Alteration in Circadian Blood Pressure Pattern in Prehypertensives
Josipa Josipović
; Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Catholic University of Croatia, School of Medicine, Zagreb, Croatia
*
Livija Šimičević
; Department of Laboratory Diagnostics, Zagreb University Hospital Center, School of Medicine, University of Zagreb, Zagreb, Croatia
Živka Dika
; Department of Nephrology, Hypertension, Dialysis and Transplantation, Zagreb University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Nikola Bulj
; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Cardiology and Angiology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mislav Vrsalović
; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Cardiology and Angiology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Bojan Jelaković
; Department of Nephrology, Hypertension, Dialysis and Transplantation, Zagreb University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
* Corresponding author.
Abstract
Although changes in dietary sodium intake alter blood pressure (BP) in salt-sensitive
individuals, pathophysiological mechanisms are still unknown. It has been reported that uromodulin is
involved in sodium tubular transport, and genome-wide association studies pointed to UMOD gene as
one of the most important gene candidates for arterial hypertension. Our aim was to analyze urinary
uromodulin, salt intake and BP in 326 young middle-aged subjects (mean age 36±8 years, 49.4% male).
In a subgroup of 175 individuals, ambulatory blood pressure monitoring and echocardiogram were performed.
Uromodulin was determined by ELISA. According to the JNC-7 criteria, subjects were classified
as optimal BP (n=103, men 72%), prehypertension (PHT) (n=143, men 43%) and hypertension
(HT) (n= 80, men 38%). There were no differences in age, salt intake, estimated glomerular filtration
rate, sodium excretion and uromodulin among BP groups. However, in PHT subjects, uromodulin was
positively associated with fractional sodium excretion and negatively with 24-h sodium excretion and
diastolic BP dip. These findings point to the effect of uromodulin on sodium reabsorption along the
nephron and consequently circadian BP alteration in prehypertensives.
Keywords
Uromodulin; Sodium excretion; Ambulatory blood pressure monitoring; Prehypertension
Hrčak ID:
308648
URI
Publication date:
1.8.2023.
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