Abstract
Mean arterial pressure drives pressure-natriuresis and determines arterial structure and function. In a population sample, we investigated the relation between arterial characteristics and renal sodium handling as assessed by the clearance of endogenous lithium. We ultrasonographically measured diameter, cross-sectional compliance (CC) and distensibility (DC) of the carotid, brachial, and femoral arteries in 1069 untreated subjects (mean age: 41.6 years; 50.1% women; 18.8% hypertensive subjects). While accounting for covariates and standardizing for the sodium excretion rate in both sexes, CC and DC of the femoral artery increased with higher fractional distal sodium reabsorption. Differences associated with a 1-SD change in fractional distal reabsorption of sodium were 51.7 mm(2)/kPax10(-3) (95% CI: 23.9 to 79.5; P=0.0002) and 0.56x10(-3)/kPa (95% CI: 0.17 to 0.94; P=0.004) for femoral CC and DC, respectively. In women as well as in men, a 1-SD increment in fractional proximal sodium reabsorption was associated with decreases in femoral and brachial diameter, amounting to 111.6 mum (95% CI: 38.2 to 185.1; P=0.003) and 52.5 mum (95% CI: 10.0 to 94.9; P=0.016), respectively. There was no consistent association between the properties of the elastic carotid artery and renal sodium handling. In conclusion, higher fractional sodium reabsorption in the distal nephron is associated with higher femoral CC and DC, and higher proximal sodium reabsorption is associated with decreased brachial and femoral diameters. These findings demonstrate that there might be an influence of renal sodium handling on arterial properties or vice versa or that common mechanisms might influence both arterial and renal function.
Highlights
Mean arterial pressure drives pressure–natriuresis and determines arterial structure and function
The fractional excretion of lithium (FELi) and fractional distal reabsorption of sodium (RNadist) are noninvasive markers of proximal tubular sodium handling and the proportion of sodium escaping reabsorption in the proximal tubule that is not eliminated in the urine, respectively.[1]
The key finding of our study was that while accounting for covariates and standardizing for the sodium excretion rate, the CC and DC of the femoral artery increased with higher distal sodium reabsorption, whereas the brachial and femoral diameters lessened with higher proximal sodium reabsorption
Summary
Mean arterial pressure drives pressure–natriuresis and determines arterial structure and function. Higher fractional sodium reabsorption in the distal nephron is associated with higher femoral CC and DC, and higher proximal sodium reabsorption is associated with decreased brachial and femoral diameters These findings demonstrate that there might be an influence of renal sodium handling on arterial properties or vice versa or that common mechanisms might influence both arterial and renal function. Expressing the renal clearance of endogenous lithium as a fractional excretion provides a measure that is factored for the glomerular filtration rate This limits possible sources of bias, such as differences in flow rate and incomplete urine collection. In the framework of the Flemish Study on Environment, Genes and Health Outcomes (FLEMENGHO), we investigated the functional and structural properties of 3 large arteries in relation to renal sodium handling as assessed by the clearance of endogenous lithium. We measured plasma renin activity and the urinary aldosterone excretion rate
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