Racial Differences in Urinary Potassium Excretion

Turban, Sharon; Miller, Edgar R.; Ange, Brett A.; Appel, Lawrence J.

doi:10.1681/asn.2007101142

Cited by 59 publications

(55 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another recent study showed lower 24-h urinary potassium excretion rates for black than white women (35). This finding has now been extended to men as well (36). Among participants in the Dietary Approaches to Stop Hypertension (DASH) study, urinary potassium excretion was lower in black individuals, a phenomenon that persisted despite low potassium diet, suggesting that factors other than dietary intake are responsible.…”

Section: Discussionmentioning

confidence: 92%

Screening for Chronic Kidney Disease Complications in US Adults

Ibrahim

Wang

Ishani

et al. 2008

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives: An ideal and effective screening tool should perform equally across ethnic groups. The objective of this study was to determine whether the widely advocated creatinine-based estimated GFR (eGFR) threshold of 60 ml/min per 1.73 m 2 identifies the typical metabolic abnormalities related to chronic kidney disease equally well in minority and nonminority adults.Design, setting, participants, & measurements: This objective was addressed using data for 8918 minority and nonminority adult participants in the National Health and Nutrition Examination Survey 2003 through 2006, which used stratified, multistage, probability sampling methods to assemble a nationwide probability sample of the noninstitutionalized population of the United States. Metabolic abnormalities including BP, potassium, hemoglobin, bicarbonate, uric acid, calcium, phosphorus, and parathyroid hormone were defined by fifth or 95th percentile values.Results: Among participants with eGFR <60 ml/min per 1.73 m 2 , black individuals were more likely than white individuals to have low hemoglobin (adjusted odds ratio [aOR] 3.76; 95% confidence interval [CI] 1.94 to 7.28), elevated uric acid (aOR 2.15; 95% CI 1.26 to 3.68), and elevated parathyroid hormone (aOR 3.93; 95% CI 2.33 to 6.66).Conclusions: Metabolic consequences of reduced eGFR are more common in black individuals and seem to be present at levels well above 60 ml/min per 1.73 m 2 ; thus, black individuals should be screened for the metabolic complications of chronic kidney at higher GFR levels.

show abstract

Section: Discussionmentioning

confidence: 92%

Screening for Chronic Kidney Disease Complications in US Adults

Ibrahim

Wang

Ishani

et al. 2008

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Previous data raise the interesting question of whether differences in intake between races are primary, or secondary and subsequent to primary differences in renal tubular handling and excretion, or due to differences in gastrointestinal absorption. Turban et al (11) reported that baseline urinary K + excretion was significantly lower in blacks compared with whites, which was maintained after an 8-week consumption of the DASH diet. One proposed mechanism is augmented furosemide-sensitive Na + -K + -2Cl 2 cotransporter activity in the thick ascending limb of Henle's loop in blacks, which leads to increased fractional Na + reabsorption upstream to the location of the epitheliumlike sodium channel, reducing tubular flow and Na + delivery and resulting in less K + excretion (8).…”

Section: Discussionmentioning

confidence: 99%

“…Although the pathogenesis of primary hypertension is still not well understood, a variety of modifiable factors such as diet, especially one high in sodium (Na + ) and low in potassium (K + ) content, have been implicated as mechanisms. Classic studies and observational data implicate that the combined effect of low K + and high Na + on BP seems greater than either alone, especially in blacks or African Americans (5)(6)(7)(8)(9)(10)(11)(12)(13). We suggested a role for WNK1 (with no lysine [K]) as a mediator of renal Na + retention and salt-sensitive hypertension in a state of dietary K + deficiency (12,13).…”

Section: Introductionmentioning

confidence: 86%

Association of Urinary Sodium/Potassium Ratio with Blood Pressure

Hedayati

Minhajuddin²,

Ijaz³

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Previous studies reporting an association between high BP and high sodium and low potassium intake or urinary sodium/potassium ratio (U[Na + ]/[K + ]) primarily included white men and did not control for cardiovascular risk factors.Design, setting, participants, & measurements This cross-sectional study investigated the association of U[Na + ]/ [K + ] with BP in 3303 participants using robust linear regression.Results Mean age was 43610 years, 56% of participants were women, and 52% were African American. BP was higher in African Americans than in non-African Americans, 131/81620/11 versus 120/76616/9 mmHg (P,0.001). Mean U[Na + ]/[K + ] was 4.463.0 in African Americans and 4.162.5 in non-African Americans (P=0.002), with medians (interquartile ranges) of 3.7 (3.2) and 3.6 (2.8). Systolic BP increased by 1.6 mmHg (95% confidence interval, 1.0, 2.2) and diastolic BP by 1.0 mmHg (95% confidence interval, 0.6, 1.4) for each 3-unit increase in U[Na + ]/[K + ] (P,0.001 for both). This association remained significant after adjusting for diabetes mellitus, smoking, body mass index, total cholesterol, GFR, and urine albumin/creatinine ratio. There was no interaction between African-American race and U[Na + ]/[K + ], but for any given value of U[Na + ]/[K + ], both systolic BP and diastolic BP were higher in African Americans than in non-African Americans. The diastolic BP increase was higher in men than in women per 3-unit increase in U[Na + ]/[K + ] (1.6 versus 0.9 mmHg, interaction P=0.03).Conclusions Dietary Na + excess and K + deficiency may play an important role in the pathogenesis of hypertension independent of cardiovascular risk factors. This association may be more pronounced in men than in women.

show abstract

“…African Americans have a higher prevalence of both diabetes and prediabetes (10,11), and potassium homeostasis may contribute to these disparities. Potassium homeostasis differs by race (12)(13)(14)(15)(16), and the association between low-normal serum potassium and increased diabetes risk has been found to be stronger in African Americans than in whites (6,17). If relative hypokalemia is a potential risk factor for diabetes and a contributor to the racial disparity in diabetes risk, then potassium supplementation, dietary or pharmacologic, which is a potentially inexpensive, well-tolerated, and simple intervention, could improve glucose metabolism and potentially reduce diabetes risk, especially in this high-risk population.…”

Section: Introductionmentioning

confidence: 99%

Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Chatterjee

Slentz

Davenport

et al. 2017

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

Background: Low potassium has been identified both as a risk factor for type 2 diabetes and as a mediator of the racial disparity in diabetes risk. Low potassium could be a potentially modifiable risk factor, particularly for African Americans. Objective: We sought to determine the effects of potassium chloride (KCl) supplements, at a commonly prescribed dose, on measures of potassium and glucose metabolism. Design: Among African-American adults with prediabetes, we conducted a double-blinded pilot randomized controlled trial that compared the effects of 40 mEq K/d as KCl supplements with a matching placebo, taken for 3 mo, on measures of potassium and glucose metabolism, with measures collected from frequently sampled oral-glucose-tolerance tests (OGTTs). Results: Twenty-seven of 29 recruited participants completed the trial. Participants had high adherence to the study medication (92% by pill count). Participants in both groups gained weight, with an overall mean 6 SD weight gain of 1.24 6 2.03 kg. In comparison with participants who received placebo, urine potassium but not serum potassium increased significantly among participants randomly assigned to receive KCl (P = 0.005 and 0.258, respectively). At the end of the study, participants taking KCl had stable or improved fasting glucose, with a mean 6 SD change in fasting glucose of 21.1 6 8.4 mg/dL compared with an increase of 6.1 6 7.6 mg/dL in those who received placebo (P = 0.03 for comparison between arms). There were no significant differences in glucose or insulin measures during the OGTT between the 2 groups, but there was a trend for improved insulin sensitivity in potassium-treated participants. Conclusions: In this pilot trial, KCl at a dose of 40 mEq/d did not increase serum potassium significantly. However, despite weight gain, KCl prevented worsening of fasting glucose. Further studies in larger sample sizes, as well as with interventions to increase serum potassium more than was achieved with our intervention, are indicated to definitively test this potentially safe and inexpensive approach to reducing diabetes risk. This trial was registered at clinicaltrials.gov as NCT02236598.

show abstract

Racial Differences in Urinary Potassium Excretion

Cited by 59 publications

References 30 publications

Screening for Chronic Kidney Disease Complications in US Adults

Screening for Chronic Kidney Disease Complications in US Adults

Association of Urinary Sodium/Potassium Ratio with Blood Pressure

Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Contact Info

Product

Resources

About