Insulin Effect on Renal Sodium Reabsorption in Adolescent Offspring of Essential Hypertensive Parents

Grunfeld, B; Giménez, María Isabel; Balzaretti, Marta; Rabinovich, Laura; Romo, Miriam; Simsolo, Rosa B.

doi:10.1161/01.hyp.26.6.1089

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…12, 13 We have also been able to show a reduced ability of the kidney to excrete sodium in normotensive adolescents, offspring of hypertensive parents, in whom we reported an increased fractional proximal renal sodium reabsorption, evaluated through the fractional excretion of lithium. 7 In this study there was very little difference in blood pressure between the three groups. The finding of an increased fractional proximal sodium reabsorption in offspring of hypertensive parents could reflect an abnormality preceding the development of high blood pressure.…”

Section: Discussionmentioning

confidence: 50%

“…5,6 We have previously reported abnormalities in the renal excretion of sodium in normotensive adolescent offspring of essential hypertensive parents. 7 The fact that not all obese individuals have high blood pressure and that offspring of hypertensive parents have sodium reabsorption abnormalities led us to evaluate the role of a family history of hypertension versus obesity in the renal handling of sodium in normotensive obese adolescents with and without a family history of hypertension. 2 ) were included in the study.…”

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confidence: 99%

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Family history of essential hypertension versus obesity as risk factors for hypertension in adolescents

Simsolo

Romo

Rabinovich

et al. 1999

American Journal of Hypertension

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Family history of hypertension and obesity are both risk factors for hypertension. Hypertension and obesity share several physiopathologic abnormalities and are frequently associated. However, not all obese people are hypertensive. Renal handling of sodium has been proposed as a physiopathogenic mechanism of essential hypertension and obesity. This study was conducted in obese adolescents to evaluate the role of a family history of hypertension versus obesity in the renal handling of sodium. .5% ؎ 1.3%, in ON it was 22.4% ؎ 2.3%, and in LH it was 14.4% ؎ 1.2% (P < .05). FEUA in OH was 8.5% ؎ 0.8%, in ON it was 14.8% ؎ 3.6%, and in LH it was 7.9% ؎ 0.8% (P < .01). Plasma renin activity (PRA) and aldosterone (PA) were measured in OH and LH; PRA was 5.3 ؎ 0.4 and 4.5 ؎ 0.4 ng/mL/h, respectively (P ‫؍‬ NS), and PA was 366 ؎ 36 and 242 ؎ 32 pg/mL, respectively (P < .05). In summary, adolescents with a family history of hypertension, regardless of their body mass, have a diminished FELi and FEUA. Obese adolescents also have higher plasma levels of aldosterone than lean ones. In conclusion, the family history of hypertension would be related to the increased renal proximal sodium reabsorption whereas obesity would be related to increased distal sodium reabsorption mechanisms, such as aldosterone. Both mechanisms could explain the higher prevalence of hypertension in obese offspring of hypertensive parents. Am J Hypertens 1999;12:260 -263

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Section: Discussionmentioning

confidence: 50%

mentioning

confidence: 99%

Family history of essential hypertension versus obesity as risk factors for hypertension in adolescents

Simsolo

Romo

Rabinovich

et al. 1999

American Journal of Hypertension

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“…Nevertheless, this does not exclude the possibility that insulin may affect renal tubular sodium reabsorption at a site distal to the proximal tubule. 49 In summary, comparing black and white patients with essential hypertension, black race was a stronger predictor of cardiac size and inulin and lithium clearances than either blood pressure or any of the components of the insulin resistance syndrome. In addition, blood pressure was associated with concentric left ventricular hypertrophy in both patient groups, and in blacks, microalbumin excretion and glomerular hyperfiltration were also related to the insulin resistance syndrome.…”

Section: Discussionmentioning

confidence: 91%

Predictors of Target Organ Damage in Hypertensive Blacks and Whites

et al. 2001

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Abstract-The purpose of this study was to evaluate the association of the insulin resistance syndrome with both blood pressure and target organ damage in blacks and whites with essential hypertension. Eighty-two black and 63 white French Canadian patients were studied. None had diabetes, and antihypertensive medications had been discontinued for Ն1 week. Key Words: hypertrophy Ⅲ glomerular filtration rate Ⅲ insulin resistance Ⅲ microalbumin Ⅲ race Ⅲ target organ damage R esistance to insulin-stimulated glucose uptake is a complex phenotype with both genetic and lifestyle contributory factors. The insulin resistance syndrome includes central obesity, hyperinsulinemia, dyslipidemia, hypertension, hypercoagulability, and an increased potential for developing atherosclerotic disease. 1 The possibility that insulin resistance and hyperinsulinemia may contribute to elevated arterial pressure in patients with essential hypertension has generated considerable interest, and a number of putative mechanisms have been proposed. 2-4 However, results of epidemiological and clinical studies describing the relationship of insulin resistance and/or hyperinsulinemia to hypertension or to the development of hypertension are conflicting. 5 Some reports suggest that the relationship between insulin resistance and hypertension is less striking in blacks than in whites. 6 Among hypertensives, both renal disease and cardiac disease have been related to the insulin resistance syndrome. Microalbuminuria is a strong predictor of cardiovascular and renal disease risk. 7 Several 8 -10 but not all 11,12 reports describe an association of plasma insulin concentrations and/or indexes of insulin resistance with microalbuminuria. Glomerular hyperfiltration, a functional renal change that precedes glomerulosclerosis, 13-15 is associated with obesity, 16 and obesity augments the effect of hypertension on albuminuria. 17 Furthermore, in obese hypertensives, higher glomerular filtration rate (GFR) is associated with insulin resistance. 18 Insulin exerts a growth-stimulating effect on cardiac myocytes and increases collagen production in fibroblasts. 19 Several studies suggest that insulin resistance and/or hyperinsulinemia also contribute to concentric left ventricular hypertrophy and diastolic dysfunction in normotensives and hypertensives. 20,21 Blacks are at greater risk for developing hypertension related target organ disease than whites. Hypertensive blacks have a greater rate of decline of renal function over time than do whites, 22 and black men have a 4-fold-higher incidence of

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“…It is well known that hyperinsulinemia activates Na + /H + pump in PCT resulting in increased uptake of Na + and shedding more H + . This is accompanied by higher reabsorption of water, potassium, and bicarbonate [21, 22]. …”

Section: Discussionmentioning

confidence: 99%

Impact of Gentamicin Coadministration along with High Fructose Feeding on Progression of Renal Failure and Metabolic Syndrome in Sprague-Dawley Rats

Ibraheem

Basir

Aljobory

et al. 2014

BioMed Research International

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The current study evaluates the impact of high fructose feeding in rat model of gentamicin induced nephrotoxicity. Sprague-Dawley rats weighing 180–200 g were randomized into four groups; (C) received standard rodents chow with free access to ad libitum drinking water for 8 weeks and was considered as control, (F) received standard rodents chow with free access to drinking water supplemented with 20% (W/V) fructose for the same abovementioned period, (FG) was fed as group F and was given 80 mg/kg (body weight)/day gentamicin sulphate intraperitoneally during the last 20 days of the feeding period, and (G) was given gentamicin as above and fed as group C. Renal function was assessed at the end of the treatment period through measuring serum creatinine, uric acid and albumin, creatinine clearance, absolute and fractional excretion of both sodium and potassium, twenty-four-hour urinary excretion of albumin, and renal histology. For metabolic syndrome assessment, fasting plasma glucose and insulin were measured and oral glucose tolerance test was performed throughout the treatment period. Results showed that gentamicin enhances progression of fructose induced metabolic syndrome. On the other hand, fructose pretreatment before gentamicin injection produced a comparable degree of renal dysfunction to those which were given fructose-free water but the picture of nephrotoxicity was somewhat altered as it was characterized by higher extent of glomerular congestion and protein urea. Overall, more vigilance is required when nephrotoxic drugs are prescribed for patients with fructose induced metabolic syndrome.

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Insulin Effect on Renal Sodium Reabsorption in Adolescent Offspring of Essential Hypertensive Parents

Cited by 9 publications

References 17 publications

Family history of essential hypertension versus obesity as risk factors for hypertension in adolescents

Family history of essential hypertension versus obesity as risk factors for hypertension in adolescents

Predictors of Target Organ Damage in Hypertensive Blacks and Whites

Impact of Gentamicin Coadministration along with High Fructose Feeding on Progression of Renal Failure and Metabolic Syndrome in Sprague-Dawley Rats

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