Key result
Nighttime hypertension shows no independent link to adverse kidney outcomes in IgA nephropathy.
Why the study?
The prognostic value of ambulatory blood pressure monitoring for long-term kidney outcomes in patients with IgA nephropathy had not been evaluated.
Does nighttime hypertension assessed by ambulatory blood pressure monitoring at biopsy predict long-term kidney outcomes in patients with biopsy-confirmed IgA nephropathy?
Cohort (n=113)
Does nighttime hypertension assessed by ambulatory blood pressure monitoring at biopsy predict long-term kidney outcomes in patients with biopsy-confirmed IgA nephropathy?
In patients with biopsy-confirmed IgA nephropathy, nighttime hypertension detected via ambulatory blood pressure monitoring is associated with worse unadjusted kidney survival over 8.5 years, though it is not an independent predictor after adjusting for baseline eGFR and proteinuria.
Answers are grounded in this paper and cite their sources.
Does not support using nighttime hypertension for independent risk prediction in IgA nephropathy; leaves open whether ambulatory monitoring adds value beyond eGFR and proteinuria.
The importance of blood pressure control in improving kidney outcomes in patients with immunoglobulin A nephropathy ( IgAN) has long been recognized. However, no study has evaluated the prognostic value of ambulatory blood pressure ( ABP) monitoring, the most reliable method of blood pressure assessment in routine clinical practice, in patients with IgAN. Our previous cross-sectional study on IgAN identified links between the findings obtained in ABP monitoring at the biopsy diagnosis, as well as clinicopathological findings [1 ]. In this study, we performed a longitudinal follow-up study to identify the ABP findings at biopsy that were associated with long-term kidney outcomes in the same cohort of IgAN patients. The detailed methods of the study are described in the Supplementary data, Methods. This study included 113 patients with biopsy-confirmed IgAN. Both groups of patients classified as having daytime and nighttime hypertension had a higher proportion of patients with established clinical risk factors for IgAN progression, such as reduced estimated glomerular filtration rate ( eGFR) and overt proteinuria at biopsy ( Supplementary data, Table S1) [2 ]. During a median follow-up period of 8.5 years, 29 patients ( 26%)
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Ikeda et al. (2025) conducted a cohort in Immunoglobulin A nephropathy (IgAN) (n=113). Nighttime hypertension on ambulatory blood pressure monitoring vs. Absence of nighttime hypertension was evaluated on Composite kidney outcome defined as a 40% reduction in eGFR or the initiation of kidney replacement therapy. Nighttime hypertension at biopsy was not independently associated with long-term kidney outcomes after adjusting for reduced eGFR and overt proteinuria in patients with IgA nephropathy.
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