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Clin Chim Acta ; 421: 236-42, 2013 Jun 05.
Article in English | MEDLINE | ID: mdl-23454474

ABSTRACT

BACKGROUND: Salt sensitivity (SS) of blood pressure (BP) affects 25% of adults, shares comorbidity with hypertension, and has no convenient diagnostic test. We tested the hypothesis that urine-derived exfoliated renal proximal tubule cells (RPTCs) could diagnose the degree of an individual's SS of BP. METHODS: Subjects were selected who had their SS of BP determined 5 y prior to this study (salt-sensitive: ≥7 mm Hg increase in mean arterial pressure (MAP) following transition from a random weekly diet of low (10 mmol/day) to high (300 mmol/day) sodium (Na(+)) intake, N=4; inverse salt-sensitive (ISS): ≥7 mm Hg increase in MAP transitioning from a high to low Na(+) diet, N=3, and salt-resistant (SR): <7 mm Hg change in MAP transitioned on either diet, N=5). RPTC responses to 2 independent Na(+) transport pathways were measured. RESULTS: There was a negative correlation between the degree of SS and dopamine-1 receptor (D1R) plasma membrane recruitment (y=-0.0107x+0.68 relative fluorescent units (RFU), R(2)=0.88, N=12, P<0.0001) and angiotensin II-stimulated intracellular Ca(++) (y=-0.0016x+0.0336, R(2)=0.7112, P<0.001, N=10) concentration over baseline. CONCLUSIONS: Isolating RPTCs from urine provides a personalized cell-based diagnostic test of SS index that offers advantages over a 2-week controlled diet with respect to cost and patient compliance. Furthermore, the linear relationship between the change in MAP and response to 2 Na(+) regulatory pathways suggests that an individual's RPTC response to intracellular Na(+) is personalized and predictive.


Subject(s)
Arterial Pressure/drug effects , Epithelial Cells/drug effects , Kidney Tubules, Proximal/drug effects , Sodium, Dietary/pharmacology , Angiotensin II/genetics , Angiotensin II/metabolism , Biomarkers/metabolism , Calcium/metabolism , Cell Separation , Cells, Cultured , Epithelial Cells/cytology , Epithelial Cells/metabolism , Gene Expression , Humans , Kidney Tubules, Proximal/cytology , Kidney Tubules, Proximal/metabolism , Receptors, Dopamine D1/genetics , Receptors, Dopamine D1/metabolism , Sodium, Dietary/metabolism
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