Ethnic differences in proximal and distal tubular sodium reabsorption are heritable in black and white populations
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BACKGROUND: Segmental handling of sodium along the proximal and distal nephron might be heritable and different between black and white participants. METHODS: We randomly recruited 95 nuclear families of black South African ancestry and 103 nuclear families of white Belgian ancestry. We measured the (FENa) and estimated the fractional renal sodium reabsorption in the proximal (RNaprox) and distal (RNadist) tubules from the clearances of endogenous lithium and creatinine. In multivariable analyses, we studied the relation of RNaprox and RNadist with FENa and estimated the heritability (h) of RNaprox and RNadist. RESULTS: Independent of urinary sodium excretion, South Africans (n = 240) had higher RNaprox (unadjusted median, 93.9% vs. 81.0%; P < 0.001) than Belgians (n = 737), but lower RNadist (91.2% vs. 95.1%; P < 0.001). The slope of RNaprox on FENa was steeper in Belgians than in South Africans (-5.40 +/- 0.58 vs. -0.78 +/- 0.58 units; P < 0.001), whereas the opposite was true for the slope of RNadist on FENa (-3.84 +/- 0.19 vs. -13.71 +/- 1.30 units; P < 0.001). h of RNaprox and RNadist was high and significant (P < 0.001) in both countries. h was higher in South Africans than in Belgians for RNaprox (0.82 vs. 0.56; P < 0.001), but was similar for RNadist (0.68 vs. 0.50; P = 0.17). Of the filtered sodium load, black participants reabsorb more than white participants in the proximal nephron and less postproximally. CONCLUSION: Segmental sodium reabsorption along the nephron is highly heritable, but the capacity for regulation in the proximal and postproximal tubules differs between whites and blacks.
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The increased cardiovascular risk in Black populations may be due to physiological differences including a suppressed RAAS, altered renal sodium handling, increased cardiovascular reactivity, and early vascular aging (large artery stiffness).
“This increased cardiovascular risk may be due to physiological differences including a suppressed RAAS, 133,134 altered renal sodium handling, 135 increased cardiovascular reactivity, 136 and early vascular aging (large artery stiffness). 137”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [135]
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- Authors
- Bochud, M., Staessen, J. A., Maillard, M., Mazeko, M. J., Kuznetsova, T., Woodiwiss, A., Richart, T., Norton, G., Thijs, L., Elston, R., & Burnier, M.
- Affiliations
- Institute of Social and Preventive Medicine (CH)
- KU Leuven (BE)
- Centre Hospitalier Universitaire Vaudois (CH)
- University of the Witwatersrand (ZA)
- Corresponding author
- Staessen, Jan A
- ORCID
- Venue
- Journal of Hypertension
- Published
- 2009-03
- Volume
- 27
- Issue
- 3
- Pages
- 606-612
- ISSN
- 0263-6352 (ISSN-L)
- PMC
- PMC3683574
- OpenAlex
- W2031072276
- Cited by
- 63
- References
- 36
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 1 · 2022: 4 · 2021: 8 · 2020: 10 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 3
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IRIS (submittedVersion)
- Lirias (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Funders
- National Research Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (111361, 111362)
- Circulatory Disorders Research Fund
- Medical Research Council
- National Institute of General Medical Sciences (GM-28356, R37GM028356, R01GM028356)
- National Center for Research Resources (P41RR003655)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
- Keywords
- sodium reabsorption, proximal tubule, distal tubule, heritability, fractional excretion of sodium, ethnic differences, black and white populations, nuclear family, lithium clearance, creatinine clearance, South Africans
- MeSH terms
- Absorption, Adult, Belgium, Creatinine, Female, Genetics, Population, Humans, Kidney Tubules, Distal, Kidney Tubules, Proximal, Lithium, Male, Metabolic Clearance Rate, Middle Aged, Nephrons, Nuclear Family, Sodium, South Africa, Black People, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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