Prognostic value of morning blood pressure surge in chronic kidney disease

Objective: To investigate the prognostic value of morning blood pressure surge (MBPS) in chronic kidney disease (CKD). Methods: We investigated the occurrence of a composite endpoints (coronary events, stroke, and heart failure requiring hospitalization, end-stage renal disease, death) in 153 patients (aged ³18 years) with a diagnosis of in CKD. Based on MBPS defined as ≥35 mmHg, patients were divided into a two groups: with MBPS (n = 50) and without MBPS (n = 103). The follow-up period was ³10 months. Baseline demographic, laboratory and follow-up data were collected. The clinical characteristics of the two groups were compared. The relationships between MBPS and endpoint events were analyzed using the Kaplan–Meier method and Cox regression model. Results: In total, 153 patients ( mean age 41.8 years; 56.86% males) were included in this study. During the follow-up period (mean 4.3 years), 34 endpoint events occurred. After adjustment for the covariates, the risk of Cardiovascular and cerebrovascular events, end-stage renal disease and death remained significantly higher in patients with MBPS [hazard ratio (HR) and 95% confidence interval (CI) 3.124 (1.096–9.130)]. Among the other variables, 24-h systolic blood pressure, and night-time and daytime pulse pressures remained significantly associated with outcome in patients of CKD [1.789 (1.205–2.654), 1.710 (1.200–2.437), and 1.318 (1.096–1.586), respectively]. Conclusion: MBPS was identified as an independent prognostic factor for composite endpoint events (coronary events, stroke, and heart failure requiring hospitalization, end-stage kidney disease) patients with chronic kidney disease patients.