Exploring the Role of the Gut-Kidney Axis in Determining Salt Sensitivity Phenotypes Among Normotensive Individuals: A Cross-Sectional Study
Abstract
Background: Salt sensitivity of blood pressure varies markedly among individuals, even in normotensive populations, and is increasingly linked to gut microbial composition and function. Emerging evidence supports the gut–kidney axis as a critical regulator of sodium handling, inflammation, and vascular tone. However, data in normotensive individuals remain limited. Objective: To identify whether specific gut microbiome profiles predict blood pressure responses to high dietary sodium intake among normotensive adults. Methods: A cross-sectional study was conducted at a tertiary care hospital in Islamabad over eight months. Ninety normotensive participants (aged 20–50 years) were enrolled and subjected to a controlled low-sodium diet (3 g/day NaCl) for seven days followed by a high-sodium diet (18 g/day NaCl) for another seven days. Blood pressure was monitored daily, and salt sensitivity was defined as a ≥10 mmHg increase in mean arterial pressure (MAP) after the sodium challenge. Stool samples were analyzed using 16S rRNA sequencing (Illumina MiSeq) to assess microbial diversity and composition. Statistical analyses included t-tests, Pearson correlations, and multivariate linear regression, with p<0.05 considered significant. Results: Salt-sensitive individuals (n=45) exhibited significantly greater increases in systolic, diastolic, and mean arterial pressure (ΔMAP = 9.1 ± 3.2 mmHg) compared to salt-resistant participants (ΔMAP = 1.8 ± 1.4 mmHg; p<0.001). Microbiome diversity…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 45 participants or records.
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