Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;38(4):671-678.
doi: 10.1097/HJH.0000000000002324.

Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results

Alejandro G Martinez-Aguayo  1   2 , Carmen Campino  2   3   4 , Maria Rodriguez-Fernandez  5 , Helena Poggi  1 , Ivonne D'apremont  1 , Rosario Moore  1 , Hernan Garcia  1   2 , Sandra Solari  2   6 , Fidel Allende  2   6 , Soledad Peredo  1 , Claudia Trincado  1 , Cristian Carvajal  2   3   4 , Monica Arancibia  1 , Jose Tomas Ossa  1 , Sofia Sifaqui  1 , Carlos E Fardella  2   3   4 , Rene Baudrand  2   3
Affiliations

Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results

Alejandro G Martinez-Aguayo et al. J Hypertens. 2020 Apr.

Abstract

Objectives: To identify associations among the plasma renin concentration (PRC), plasma aldosterone and urinary sodium (Na)/potassium (K) ratio, and to integrate these variables into a nomogram with the aim of estimating the expected versus observed aldosterone concentration.

Methods: We studied 40 healthy normotensive children (5-8 years old, 57.5% girls) who were born at term and were adequate for their gestational age. Following overnight fasting, the PRC and plasma aldosterone in blood samples were measured, and the Na/K ratio was calculated from a simultaneously obtained urinary spot sample. A mathematical function was defined with these three variables, and a nomogram was built that would return the expected aldosterone concentration from the obtained plasma renin and urinary Na/K ratio values.

Results: The PRC (B = 5.9, P < 0.001) and urinary Na/K ratio (B = -98.1, P = 0.003) were significant independent predictors of plasma aldosterone. The correlation between the observed plasma aldosterone and the expected plasma aldosterone, as obtained from the nomogram, was r = 0.88, P < 0.001. The average difference between the observed and expected plasma aldosterone was -0.89, with a standard deviation of ±30%.

Conclusion: The strong correlation between the urinary Na/K ratio, from urine samples taken at the same as the blood samples, and plasma renin and aldosterone concentrations allowed us to build a nomogram to predict aldosterone levels. This approach may be useful for evaluating the renin-angiotensin-aldosterone system (RAAS) in pediatric patients with hypertension and RAAS dysfunction.

PubMed Disclaimer

References

    1. Flynn JT, Daniels SR, Hayman LL, Maahs DM, McCrindle BW, Mitsnefes M, et al. American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. Hypertension 2014; 63:1116–1135.
    1. Bancalari R, Díaz C, Martínez-Aguayo A, Aglony M, Zamorano J, Cerda V, et al. Prevalencia de hipertensión arterial y su asociación con la obesidad en edad pediátrica prevalence of hypertension in school age children and its association with obesity. Rev Med Chile 2011; 139:872–879.
    1. Flynn JT, Falkner BE. Obesity hypertension in adolescents: epidemiology, evaluation, and management. J Clin Hypertens 2011; 13:323–331.
    1. Rao G. Diagnosis, epidemiology, and management of hypertension in children. Pediatrics 2016; 138:e20153616.
    1. Gupta-Malhotra M, Banker A, Shete S, Hashmi SS, Tyson JE, Barratt MS, et al. Essential hypertension vs. secondary hypertension among children. Am J Hypertens 2015; 28:73–80.

Publication types