Key result
Early CKD is linked to a ~2.2-fold higher prevalence of non-dipping blood pressure vs controls.
Why the study?
Patients with chronic kidney disease have high cardiovascular morbidity and mortality, and aberrant circadian blood pressure patterns are linked to increased cardiovascular risk; this study investigated circadian blood pressure profiles in early-stage CKD patients.
Does early-stage chronic kidney disease (stages 1-3) increase the prevalence of a non-dipping circadian blood pressure profile compared to healthy controls?
Cross-Sectional (n=120)
No
Does early-stage chronic kidney disease (stages 1-3) increase the prevalence of a non-dipping circadian blood pressure profile compared to healthy controls?
Even in early stages of chronic kidney disease (stages 1-3), patients show a highly prevalent blunted nocturnal blood pressure decline, supporting the clinical value of routine 24-hour ambulatory blood pressure monitoring in this population to identify elevated cardiovascular risk.
Early CKD was associated with non-dipping BP; leaves open whether routine ABPM improves outcomes in stages 1–3.
Background The population of patients with chronic kidney disease (CKD) is prone to high cardiovascular morbidity and mortality. Aberrant circadian pattern of blood pressure is associated with increase cardiovascular risk. The study investigated circadian blood pressure profile in patients with early stages of CKD. Material and methods The study included 90 patients with CKD stage 1–3, aged 34–79 years and 30 healthy volunteers as control group. All patients underwent ambulatory blood pressure monitoring (ABPM). Patient was classified as “dipper” if relative decreases in SBP and DBP at night was at least 10%. If the drop the SBP or DBP was less than 10% patient was classified as “non-dipper”. Results Hypertension was present in 78.9% of patients with CKD stage 1–3. “Non-dipper” profile was found in 59 (66%) of the surveyed patients with CKD, namely in 16 (53%) in CKD stage 1, 23 (70%) in CKD stage 2, and 20 (74%) in CKD stage 3. “Non-dipper” profile was observed in 9 (30%) of control patients. In the whole study population (n = 120) significant positive correlation was found between % drop in SBP and eGFR (r = 0.25; p < 0.01). There was no significant correlation between % drop in SBP and eGFR (r = 0.12; p = 0.26) in 90 CKD patients. There was statistically significant negative correlation between % drop in SBP and age (r = –0.25; p < 0.05) and BMI (r = –0.24; p < 0.05). Conclusions “Non-dipper” profile is a common finding among patients with early stages of CKD and may be associated with a higher cardiovascular risk. ABPM should be a standard procedure in patients with CKD, even in early stages of the disease.
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Pluta et al. (2015) conducted a cross-sectional in Chronic Kidney Disease Stage 1-3 (n=120). Chronic kidney disease stage 1-3 vs. Healthy volunteers with normal renal function and no hypertension was evaluated on "Non-dipper" circadian blood pressure profile (<10% drop in night-time BP) (p=<0.005). Patients with early-stage chronic kidney disease had a significantly higher prevalence of an aberrant 'non-dipper' blood pressure profile compared to healthy controls (66% vs 30%, p<0.005).
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