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The purpose of the study was to assess the sodium and potassium intake among Hungarian children and adolescents. The study was undertaken to estimate daily sodium and potassium intake by measuring 24-h urinary electrolyte excretion rate in 200 Hungarian children (age 1–18 years). Daily sodium and potassium intake positively correlated with age, body mass index, and systolic blood pressure. As a result of the parallel trend and time course of urinary sodium and potassium excretion the sodium to potassium ratio, the important risk factor for essential hypertension remained practically unchanged with age. We did not find a significant difference in this ratio between hypertensive and normotensive, or obese and non-obese children. Sodium and potassium intake expressed per kilogram body weight decreased steadily with age, but there was no significant difference between boys and girls. When adjustment was made for age and body mass index, using multivariate regression analysis, the systolic blood pressure proved to be independent of urinary sodium excretion and daily potassium intake. Compared with Dietary Reference Intake values, the present study demonstrates that, on average, Hungarian children and adolescents have a diet rich in sodium, and poor in potassium, although during the last 20 years a favourable trend can be detected.

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Authors: J. Komlós, M. Sulyok and E. Szemerédi
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Authors: B. Sági, A. Peti, O. Lakatos, T. Gyimesi, E. Sulyok, I. Wittmann and Botond Csiky

Abstract

Objective

In this observational study we addressed accelerated arteriosclerosis (AS) in patients with chronic renal failure (CRF) on hemodialysis (HD) by measuring vascular stiffness (VS) parameters and attempted to relate them to pro-inflammatory and protective factors.

Patients

96 consecutive patients receiving regular HD were included. 20 adult patients without major renal, cardiovascular or metabolic morbidities served as controls.

Methods

AS parameters (carotid-femoral pulse wave velocity – PWV, aortic augmentation index – Aix) were measured by using applanation tonometry (SphygmoCor, AtCor Medical, Sidney). In addition to routine laboratory tests 25(OH) vitamin D3 (vitamin D3) and high-sensitivity C-reactive protein (hsCRP) were quantified by immunometric assay; whereas fetuin-A, α-Klotho, tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) were determined by ELISA.

Results

Pro-inflammatory biomarkers (hsCRP, TNF-α and TGF-β1) were markedly elevated (P < 0.01), while anti-inflammatory factors (fetuin-A: P < 0.05, α-Klotho: P < 0.01, vitamin D3: P < 0.01) significantly depressed in HD patients when compared to controls. PWV was significantly affected only by total cholesterol, fetuin-A and dialysis time. Multiple linear regression analyses revealed that several clinical and laboratory parameters were associated with pro- and anti-inflammatory biomarkers rather than VS. The impact of baseline clinical and biochemical variables on outcome measures were also analyzed after three-year follow-up, and it was demonstrated that low levels of vitamin D, α-Klotho protein and fetuin-A were related to adverse cardiovascular outcomes, whereas all-cause mortality was associated with elevated hsCRP and depressed vitamin D.

Conclusions

Our results provide additional information on the pathomechanism of accelerated AS in patients with CRF, and documented direct influence of pro- and anti-inflammatory biomarkers on major outcome measures.

Open access