| Objective:Essential hypertension refers to a syndrome with elevated arterial systolic blood pressure and(or)diastolic blood pressure as the main clinical manifestations,which is a risk factor for increasing morbidity,mortality and disability rates of cardiovascular disease and stroke worldwide.Long-term loss of blood pressure control can damage the body’s target organ functions,such as chronic kidney disease,ventricular hypertrophy,atherosclerosis,cerebrovascular ischemic or hemorrhagic diseases and so on.Which is currently one of the causes of end-stage renal disease except for diabetes and primary glomerular diseases.What’s more,there are many risk factors that cause hypertension and damage to target organs.Among them,high-sodium diet is an important dietary factor leading to high blood pressure and worsening of chronic kidney disease.The salt taste threshold is to assess the sodium sensitivity of the subject’s oral cavity by detecting the lowest sodium salt concentration at which the subject’s oral cavity recognizes salty taste.It is currently one of the important methods for assessing the subject’s sodium intake.Elevated salt taste threshold levels increase the risk of various diseases such as hypertension,coronary heart disease,chronic kidney disease,metabolic syndrome.Dietary guidance to decrease the salt threshold that can reduce the risk of these diseases.In addition,reducing the salt taste threshold of patients with chronic kidney disease can decrease the risk of end-stage renal disease and delay the deterioration of renal function in patients.However,whether the salt taste threshold is related to the risk of hypertensive nephropathy is still unclear.This study intends to compare the sensitivity of patients with hypertension and hypertensive nephropathy to different concentrations of sodium salt solution,assess their recent sodium intake,compare their salt taste sensitivity and the differences in biochemical indicators of renal function,and clarify the salt taste threshold and the effect of level on renal function in patients with hypertensive nephropathy.This study explored the relationship between salt taste sensitivity and blood pressure changes and renal function in patients with hypertension,and provided a new perspective for the population’s salt restriction strategy and the prevention and treatment of hypertensive nephropathy.Methods:According to the diagnostic criteria of hypertension,we randomly selected 507 patients with hypertension who were hospitalized in the Department of Cardiology of Daping Hospital from December 2017 to February 2019.Among them,161 cases suffering from coarctation of the aorta,primary kidney disease,renal artery stenosis,diabetic kidney damage,severe infection,shock,exposure to poisons,burns,severe myopathy,active bleeding,systemic lupus erythematosus,rheumatoid arthritis,pulmonary embolism basic participants such as malignant tumors,cachexia were excluded.After the exclusion,the remaining patients were grouped according to the diagnostic criteria of hypertensive nephropathy,of which 252 patients served as the hypertensive control group,and 94 patients meeting the diagnostic criteria of hypertensive nephropathy belonged to the hypertensive nephropathy group.With reference to the salt taste threshold detection method proposed by Nilsson B,the salt taste threshold of subjects was measured by setting 10 concentration gradient sodium salt solutions.At the same time,we collected all patients’personal information,physical examination indicators,smoking and drinking status,history of hypertension,type 2 diabetes,coronary heart disease and dyslipidemia,glucose and lipid metabolism indicators,biochemical indicators of renal function and so on.Spearman correlation analysis was used to investigate the relationship between salt taste threshold and biochemical indicators of renal function in patients with essential hypertension.Logistic regression model was used to analyze and correct the traditional risk factors of hypertensive nephropathy and clarify the salt taste threshold was a predictive risk of hypertensive nephropathy,and combine the patient’s blood pressure level and renal function biochemical indicators to establish a more accurate predictive model of hypertensive nephropathy.Results:1.Comparison of levels of salt taste threshold with biochemical indicators of blood pressure and renal function:The salt taste threshold was divided into four groups according to the quartile method.The results showed that comparing with the salt taste threshold of 0.025mol/L,the renal function biochemical indicators of the abnormal salt taste threshold of 0.05mol/L,including urine microalbumin/urinary creatinine and blood urea nitrogen increased,while e GFR decreased(all P<0.05);the salt taste threshold was 0.075 mol/L in patients with systolic blood pressure and diastolic blood pressure,urine microalbumin/urinary creatinine,blood urea nitrogen,NAG increased,and e GFR reduced(all P<0.05);the salt taste threshold was 0.1～0.4 mol/L group of patients’systolic blood pressure,diastolic blood pressure,urine microalbumin/Urinary creatinine,blood creatinine,blood urea nitrogen,and NAG levels increased,while e GFR decreased(all P<0.05).The results of trendχ~2 test showed that there was a linear trend between the salt taste threshold and the levels of systolic blood pressure,diastolic blood pressure and the above-mentioned biochemical indicators of renal function.2.Spearman correlation analysis was used to show that the salt taste threshold was positively correlated with blood creatinine,blood urea nitrogen,NAG and urine microalbumin/urine creatinine(all P<0.05);And it was negatively correlated with e GFR(P<0.01),which indicated that there was a correlation between the salt taste threshold and the biochemical indicators of renal function in patients with essential hypertension.3.Salt taste threshold and urine sodium concentration estimating daily average sodium intake:The salt taste threshold of patients with hypertensive nephropathy is 0.075(0.050～0.100)mol/L,and the estimated daily average sodium intake is 14.50(9.01～22.22)mol/L was significantly higher than the salt taste threshold of the hypertensive control group[0.050(0.050～0.100)mol/L]and the estimated sodium intake[12.58(8.53～17.14)mol/L],both P<0.05.The above results showed that the change of salt taste threshold in patients with essential hypertension was consistent with the change of urinary sodium concentration estimated daily sodium intake.4.Salt taste threshold was associated with hypertensive nephropathy:Univariate regression analysis showed that salt taste threshold was associated with hypertensive nephropathy(OR=1.347,95%CI 1.081～1.678,P=0.008).After the logistic regression analysis model adjusted for traditional risk factors,the analysis results showed that for every 0.025mol/L increased in salt taste threshold,the risk of hypertensive nephropathy increased by 1.299times(OR=1.299,95%CI 1.020～1.655,P=0.034).The results indicated that salt taste threshold was an independent risk factor for hypertensive nephropathy.Conclusions:1.Increased salt taste threshold and increased salt intake are associated with blood pressure levels and abnormal renal function indicators in hypertensive patients.2.Salt taste threshold is an independent risk factor for hypertensive nephropathy.It can be used to predict the risk of hypertensive nephropathy in patients with essential hypertension. |
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