The Dilator Response to K+ Is Reduced in the Forearm Resistance Vessels of Men with Primary Hypertension

Phillips, R. J. W.; Robinson, B. F.

doi:10.1042/cs0660237

Cited by 19 publications

(3 citation statements)

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“…The precise mechanism for how dietary potassium intake improves CV outcomes in CKD patients as well as in the general population is still unclear. Although potassium, as a potent vasodilator, reduces vascular resistance [25,26], and thereby its supplementation leads to a decrease in BP [21], the measured SBP of the subjects in the current study was not concordant with urine potassium excretion, as SBP was higher in the 3rd and 4th quartiles. We therefore hypothesize that stabilization of BPV, instead of mean BP control, may mediate the impact of dietary potassium intake on the improvement of clinical outcomes, such as eMACE.…”

Section: Discussioncontrasting

confidence: 69%

Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Suh

Song

et al. 2021

Nutrients

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Dietary potassium intake is a dilemma in patients with chronic kidney disease (CKD). We investigated the association of urine potassium excretion, a surrogate for dietary potassium intake, with blood pressure variability (BPV) and cardiovascular (CV) outcomes in patients with pre-dialysis CKD. A total of 1860 participants from a cohort of pre-dialysis CKD (KNOW-CKD) patients were divided into the quartiles by spot urine potassium-to-creatinine ratio. The first quartile (26.423 ± 5.731 mmol/gCr) was defined as low urine potassium excretion. Multivariate linear regression analyses revealed an independent association of low urine potassium excretion with high BPV (adjusted β coefficient 1.163, 95% confidence interval 0.424 to 1.901). Cox regression analyses demonstrated that, compared to high urine potassium excretion, low urine potassium excretion is associated with increased risk of CV events (adjusted hazard ratio 2.502, 95% confidence interval 1.162 to 5.387) but not with all-cause mortality. In conclusion, low urine potassium excretion is associated with high BPV and increased risk of CV events in patients with pre-dialysis CKD. The restriction of dietary potassium intake should be individualized in patients with pre-dialysis CKD.

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Section: Discussioncontrasting

confidence: 69%

Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Suh

Song

et al. 2021

Nutrients

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“…Although causality is uncertain, there are several explanations for the beneficial effects of higher urinary potassium excretion on clinical outcomes. High potassium intake can attenuate vascular resistance (35,36) and decrease BP (37), suggesting the potential benefits of potassium intake in cardiovascular disease. In fact, a previous observational study showed a significant relationship between high potassium intake and a reduced risk of stroke and death in women (38).…”

Section: Discussionmentioning

confidence: 99%

Urinary Potassium Excretion and Progression of CKD

Kim

Park

Yoo³

et al. 2019

CJASN

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Background and objectives Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression.Design, setting, participants, & measurements We investigated the relationship between lower urinary potassium excretion and CKD progression and compared three urinary potassium indices among 1821 patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassium excretion. Patients were categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a $50% decrease in eGFR from baseline values and ESKD.Results During 5326 person-years of follow-up, the primary outcome occurred in 392 (22%) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95% confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95% confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95% confidence interval, 1.51 to 9.51) for spot urinary potassium concentration.Conclusions Low urinary potassium excretion is associated with progression of CKD.

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“…In addition to lower daily acid load, plant-based diets contain high potassium, which may slow a decline in kidney function [48,49] via several proposed mechanisms including decreased vascular resistance [50,51] and blood pressure [52], lowered albuminuria [53,54], and avoiding augmented ammoniagenesis causing tubule-interstitial fibrosis [55,56]. High magnesium decreases inflammatory and proatherogenic cytokines in endothelial cells, which may lead to kidney protective effects [57,58].…”

Section: Andand 46mentioning

confidence: 99%

Paradigm shift in lifestyle modification for solitary kidney after donor nephrectomy

Tantisattamo

Kalantar‐Zadeh

2022

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of review Living donor kidney transplantation potentially leads to long-term complications including chronic kidney disease, end-stage kidney disease, elevated blood pressure, and pregnancy-associated hypertension. Given living donors generally do not have underlying medical conditions, lifestyle modifications, particularly dietary interventions may prevent those complications and improve their health outcomes. Recent findings Glomerular hyperfiltration occurs as physiologic adaptation during an initial postdonor nephrectomy period. In the long-term, these adaptations may become pathologic consequences resulting from hyperfiltration-mediated kidney injury and ultimately secondary focal segmental glomerulosclerosis in the solitary kidney. Dietary interventions to slow a decline in kidney function include low protein intake of <0.8 g/kg/day and low sodium consumption of 2–4 g/day as well as certain health dietary patterns. There is no evidence regarding the quantity and quality of protein that can be recommended for living kidney donors and the same for sodium. Plant Dominant (PLADO) diets, Dietary Approaches to Stop Hypertension (DASH), Mediterranean, and vegetarian diets may be favorable for living kidney donors with solitary kidney but the evidence is still lacking. Summary Although dietary interventions may provide benefits and kidney health for living kidney donors, further studies including clinical trials are required to incorporate them into clinical practice guidelines.

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The Dilator Response to K+ Is Reduced in the Forearm Resistance Vessels of Men with Primary Hypertension

Cited by 19 publications

References 0 publications

Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Urinary Potassium Excretion and Progression of CKD

Paradigm shift in lifestyle modification for solitary kidney after donor nephrectomy

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