Key result
Higher baseline urine uromodulin levels were not significantly associated with a greater increase in systolic blood pressure in response to high salt intake (P=0.42).
Why the study?
Because uromodulin overexpression leads to salt-induced hypertension in murine models, the authors investigated whether higher baseline urine uromodulin associates with greater systolic blood pressure increases following dietary sodium increases in humans.
Does baseline urine uromodulin level predict the change in systolic blood pressure in response to high salt intake?
RCT (n=157)
Random order crossover
Does baseline urine uromodulin level predict the change in systolic blood pressure in response to high salt intake?
p-value: p=0.42
Baseline urine uromodulin levels do not predict the magnitude of blood pressure increase in response to high dietary salt intake.
Baseline uromodulin does not predict salt-induced SBP rises; leaves open its role in hypertension phenotyping.
BACKGROUND: Uromodulin modulates the sodium-potassium-two-chloride transporter in the thick ascending limb of the loop of Henle, and its overexpression in murine models leads to salt-induced hypertension. We hypothesized that individuals with higher baseline levels of urine uromodulin would have a greater increase in systolic blood pressure (SBP) for the same increase in sodium compared with those with lower uromodulin levels. METHODS: We used data from 157 subjects randomized to the control diet of the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial who were assigned to 30 days of low (1,500 mg/d), medium (2,400 mg/d), and high salt (3,300 mg/d) diets in random order. Blood pressure was measured prerandomization and then weekly during each feeding period. We evaluated the association of prerandomization urine uromodulin with change in SBP between diets, as measured at the end of each feeding period, using multivariable linear regression. RESULTS: Baseline urine uromodulin stratified by tertiles was ≤17.64, 17.65-31.97, and ≥31.98 µg/ml. Across the tertiles, there were no significant differences in SBP at baseline, nor was there a differential effect of sodium diet on SBP across tertiles (low to high, P = 0.81). After adjusting for age, sex, body mass index, and race, uromodulin levels were not significantly associated with SBP change from low to high sodium diet (P = 0.42). CONCLUSIONS: In a randomized trial of different levels of salt intake, higher urine uromodulin levels were not associated with a greater increase in blood pressure in response to high salt intake.
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Bakhoum et al. (2020) conducted an RCT in Salt-induced blood pressure changes (n=157). High salt diet vs. Low salt diet (1,500 mg/d) was evaluated on Change in systolic blood pressure from low to high sodium diet across baseline urine uromodulin tertiles (p=0.42). Higher baseline urine uromodulin levels were not significantly associated with a greater increase in systolic blood pressure in response to high salt intake (P=0.42).
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