ASSOCIATION OF INCREASED ERYTHROCYTE NA+/H+ EXCHANGER WITH RENAL NA+ RETENTION IN PATIENTS WITH ESSENTIAL-HYPERTENSION

被引：23

作者：

DIEZ, L ^{[1
]}

ALONSO, A ^{[1
]}

GARCIANDIA, A ^{[1
]}

LOPEZ, R ^{[1
]}

GOMEZALAMILLO, C ^{[1
]}

ARRAZOLA, A ^{[1
]}

FORTUNO, A ^{[1
]}

机构：

[1] UNIV NAVARRA,SCH MED,CTR BIOMED RES,DEPT INTERNAL MED,VASC PATHOPHYSIOL UNIT,PAMPLONA,SPAIN

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1995年 / 8卷 / 02期

关键词：

ESSENTIAL HYPERTENSION; NA+/H+ EXCHANGER; NA+ EXCRETION;

D O I：

10.1016/0895-7061(94)00172-8

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

The goal of this study was to investigate the activity of the Na+/H+ exchanger in erythrocytes of patients with essential hypertension and its relation with urinary Na+ excretion. The study was performed in cells from 27 untreated hypertensive patients and 30 normotensive controls with similar age and sex distribution. All subjects were studied after 4 days on a controlled Na+ diet (145 mmol/ day). The activity of the Na+/H+ exchanger was determined by acidifying cell pH and measuring the initial rate of the net Naf-dependent Hf efflux. The activity of the Na+/H+ exchanger was higher in hypertensive patients than in controls (301 +/- 45 v 162 +/- 23 mmol/L cells/h, mean +/- SEM; P < .01). With the upper limit of the normotensive population as a cut-off point (385 mmol/L cells/h), a subgroup of 12 hypertensive patients had an abnormally high activity of Na+/H+ exchanger. Compared with controls and with patients with normal exchanger activity, patients with increased exchanger activity were characterized by lower net (P < .01) and fractional (P < .05) Na+ excretion. The accumulative Na+ balance was higher (P < .01) in hypertensive patients with increased activity of the exchanger (39.90 +/- 3.47 mmol) than in the remaining hypertensive patients (0.59 +/- 6.96 mmol) or in the normotensive population (-5.71 +/- 6.12 mmol). After analyzing the relationship of renin activity with Na+ excretion it was observed that renin activity was inappropriately low in 9 (75%) patients with increased exchanger, in 6 (40%) patients with normal exchanger, and in 6 (20%) normotensives, these differences being significant (P < .01). A reciprocal correlation was found between the activity of the exchanger and plasma renin activity in the group of hypertensive patients (r = 0.60, P < .001). These results indicate that increased activity of the erythrocyte Na+/H+ exchanger is associated with increased tubular Na+ reabsorption, Na+ retention, and low renin secretion in a subgroup of essential hypertensive patients. These findings suggest that erythrocyte Na+/H+ exchanger overactivity may be a marker of deranged Na+ handling in essential hypertension.

引用

页码：124 / 132

页数：9

共 29 条

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