A high sodium intake reduces antiproteinuric response to renin–angiotensin–aldosterone system blockade in kidney transplant recipients

A high sodium intake reduces antiproteinuric response to renin–angiotensin–aldosterone system blockade in kidney transplant recipients O A r t E J S A R A K A A A i P R K l 2 B n e f r o l o g i a 2 0[.]

Revista de la Sociedad Española de Nefrología

www r e v i s t a n e f r o l o g i a c o m

Elena Monfá, Emilio Rodrigo∗, Lara Belmar, Cristina Sango, Fozi Moussa,

Juan Carlos Ruiz San Millán, Celestino Pi ˜nera, Gema Fernández-Fresnedo, Manuel Arias

Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain

a r t i c l e i n f o

Article history:

Keywords:

Angiotensin

Angiotensin-converting-enzyme

inhibitor

Proteinuria

Renin

a b s t r a c t

Background:Post-transplantproteinuriaisassociatedwithlowergraftandpatientsurvival

Objective:Toanalysetherelationshipbetweensodiumintakeandtheantiproteinuriceffect

Methods:Weselected103kidneytransplantrecipientsreceivingACEI/ARBdrugsformore

Results:Proteinuriafelltolessthan1g/dayin46patients(44.7%).HighuNa/Crwas

Conclusions: Ahighsaltintakeresultsinasmallerproteinuriadecreaseinkidneytransplant

by-nc-nd/4.0/)

∗ Corresponding author.

La ingesta elevada de sodio disminuye la respuesta antiproteinúrica del bloqueo del eje renina-angiotensina-aldosterona en el trasplante renal

Palabras clave:

Angiotensina

angiotensina

Proteinuria

Renina

r e s u m e n

Antecedentes:Laproteinuriapostrasplanterenalseasociaaunadisminuciónenla

Objetivo:Valorarlarelaciónentrelaingestadesodioy elefectoantiproteinúricodelos

Métodos:Seleccionamosa103trasplantadostratadosconIECA/ARA-IImásde6mesespor

Resultados:En46pacientes(44,7%)laproteinuriadisminuyó<1g/día.UnuNa/Crelevadose

Conclusiones:EnlostrasplantadosrenalesconproteinuriatratadosconIECA/ARA-IIuna

by-nc-nd/4.0/)

Introduction

Methods

Study population and design

Table 1 – Patient characteristics at baseline and at 6 months.

Vascular/nephroangiosclerosis 12.6

Time from transplant to start of ACE inhibitor/ARB (days) 1097(IQR2363)

ARBs:angiotensinreceptorantagonists;CKD:chronickidneydisease;IFTA:interstitialfibrosisandtubularatrophy;ACEinhibitors: angiotensin-convertingenzymeinhibitors;mTOR:mammaliantargetofrapamycin;IQR:interquartilerange;BP:bloodpressure

Thestandarddeviationisshowninparentheses

Data collection

(Table 1 and they were extracted prospectively from the

Statistical analysis

80

40

0

–40

–80

Tertile of the Na/Cr ratio

3

Results

inTable1 Inall,55.4% ofpatientsreceivedACE inhibitors

Table2showsthefactorsthatareinrelationwithapercent

Discussion

Table 2 – Risk factors related to a percentage decrease in proteinuria of greater than 50%.

Percentage≥50%

(n=53)

Percentage<50%

(n=50)

p

Cause of proteinuria (%)

Time from transplant to start of ACE inhibitor/ARB (days) 1097(IQR2630) 1111(IQR1874) 0.444 ARBs:angiotensinreceptorantagonists;IFTA:interstitialfibrosisandtubularatrophy;ACEinhibitors:angiotensin-convertingenzymeinhibitors; mTOR:mammaliantargetofrapamycin;IQR:interquartilerange;BP:bloodpressure

Thestandarddeviationisshowninparentheses

damage We also found a relationship between changes

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