{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:42:49Z","timestamp":1792514569151,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T00:00:00Z","timestamp":1459468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Renin Angiotensin Aldosterone Syst"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Angiotensin receptor blockers (ARBs) produce a lower sodium (Na) balance, and the natriuretic effect is enhanced under Na deprivation, despite falls in blood pressure (BP) and glomerular filtration rate (GFR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The effect of additional hydrochlorothiazide (HCTZ; 12.5 mg\/day) to ARB treatment (valsartan; 80 mg\/day) on glomerulotubular Na balance was evaluated in 23 patients with chronic kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Add-on HCTZ decreased GFR, tubular Na load, and tubular Na reabsorption (t\n                      <jats:sub>Na<\/jats:sub>\n                      ), although 24-hour urinary Na excretion (U\n                      <jats:sub>Na<\/jats:sub>\n                      V) remained constant. Daily urinary angiotensinogen excretion (U\n                      <jats:sub>AGT<\/jats:sub>\n                      V, 152\u00b110\u219282\u00b117 \u03bcg\/g Cre) reduced ( p=0.02). Changes in tubular Na load ( r\n                      <jats:sup>2<\/jats:sup>\n                      =0.26) and t\n                      <jats:sub>Na<\/jats:sub>\n                      ( r\n                      <jats:sup>2<\/jats:sup>\n                      =0.25) correlated with baseline 24-hour U\n                      <jats:sub>AGT<\/jats:sub>\n                      V. Changes in filtered Na load correlated with changes in nighttime systolic BP ( r\n                      <jats:sup>2<\/jats:sup>\n                      =0.17), but not with changes in daytime systolic BP. The change in the t\n                      <jats:sub>Na<\/jats:sub>\n                      to filtered Na load ratio was influenced by the change in daytime U\n                      <jats:sub>Na<\/jats:sub>\n                      V (\u03b2=\u22120.67, F=16.8), rather than the change in nighttime U\n                      <jats:sub>Na<\/jats:sub>\n                      V.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Lower Na balance was produced by add-on HCTZ to ARB treatment without an increase of intra-renal renin-angiotensin system activity, leading to restoration of nocturnal hypertension. A further study is needed to demonstrate that the reduction of U\n                      <jats:sub>AGT<\/jats:sub>\n                      V by additional diuretics to ARBs prevents the progression of nephropathy or cardiovascular events.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1470320316652032","type":"journal-article","created":{"date-parts":[[2016,6,9]],"date-time":"2016-06-09T21:12:16Z","timestamp":1465506736000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Addition of hydrochlorothiazide to angiotensin receptor blocker therapy can achieve a lower sodium balance with no acceleration of intrarenal renin angiotensin system in patients with chronic kidney disease"],"prefix":"10.1177","volume":"17","author":[{"given":"Daisuke","family":"Fuwa","sequence":"first","affiliation":[{"name":"Department of Cardio-Renal Medicine and Hypertension, Nagoya City University 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