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Global REACH 2018: Volume regulation in high-altitude Andeans with and without chronic mountain sickness

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dc.contributor.author Steele, Andrew R.
dc.contributor.author Tymko, Michael M.
dc.contributor.author Meah, Victoria L.
dc.contributor.author Simpson, Lydia L.
dc.contributor.author Gasho, Christopher
dc.contributor.author Dawkins, Tony G.
dc.contributor.author Williams, Alexandra Mackenzie
dc.contributor.author Villafuerte, Francisco C.
dc.contributor.author Vizcardo-Galindo, Gustavo A.
dc.contributor.author Figueroa-Mujíca, Rómulo J.
dc.contributor.author Ainslie, Philip N.
dc.contributor.author Stembridge, Mike
dc.contributor.author Moore, Jonathan P.
dc.contributor.author Steinback, Craig D.
dc.date.accessioned 2021-10-04T23:00:58Z
dc.date.available 2021-10-04T23:00:58Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9833
dc.description.abstract The high-altitude maladaptation syndrome known as chronic mountain sickness (CMS) is characterized by polycythemia and is associated with proteinuria despite unaltered glomerular filtration rate. However, it remains unclear if indigenous highlanders with CMS have altered volume regulatory hormones. We assessed N-terminal pro-B-type natriuretic peptide (NT pro-BNP), plasma aldosterone concentration, plasma renin activity, kidney function (urinary microalbumin, glomerular filtration rate), blood volume, and estimated pulmonary artery systolic pressure (ePASP), in Andean males without (n=14; age=39±11) and with (n=10; age=40±12) CMS at 4330 meters (Cerro de Pasco, Peru). Plasma renin activity (non-CMS: 15.8±7.9 vs. CMS: 8.7±5.4 ng/ml; p=0.025) and plasma aldosterone concentration (non-CMS: 77.5±35.5 vs. CMS: 54.2±28.9 pg/ml; p=0.018) were lower in highlanders with CMS compared to non-CMS, while NT pro-BNP was not different between groups (non-CMS: 1394.9±214.3 vs. CMS: 1451.1±327.8 pg/ml; p=0.15). Highlanders had similar total blood volume (non-CMS: 90±15 vs. CMS: 103±18 ml • kg(-1); p=0.071), but Andeans with CMS had greater total red blood cell volume (non-CMS: 46±10 vs. CMS 66±14 ml • kg(-1); p<0.01) and smaller plasma volume (non-CMS 43±7 vs. CMS 35±5 ml • kg(-1); p=0.03) compared to non-CMS. There were no differences in ePASP between groups (non-CMS 32±9 vs. CMS 31±8 mmHg; p=0.6). A negative correlation was found between plasma renin activity and glomerular filtration rate in both groups (group: r=-0.66; p<0.01; non-CMS: r=-0.60; p=0.022; CMS: r=-0.63; p=0.049). A smaller plasma volume in Andeans with CMS may indicate an additional CMS maladaptation to high-altitude, causing potentially greater polycythemia and clinical symptoms. en_US
dc.language.iso eng
dc.publisher American Physiological Society
dc.relation.ispartofseries American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Blood volume en_US
dc.subject High-altitude en_US
dc.subject Renal function en_US
dc.subject Volume regulation en_US
dc.title Global REACH 2018: Volume regulation in high-altitude Andeans with and without chronic mountain sickness en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1152/ajpregu.00102.2021
dc.relation.issn 1522-1490


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