Longitudinal observations on circadian blood pressure variation in chronic kidney disease stages 3-5.

@article{citeulike:2959181, abstract = {BACKGROUND: It has been suggested that status as a 'non-dipper' determined from 24-h blood pressure (BP) recordings is associated with increased risk of end-organ damage but little is known about the consistency of dipper status in renal patients. The present post hoc analysis evaluated dipper/non-dipper status prospectively in a study on dosage of enalapril in progressive chronic kidney disease (CKD) stages 3-5. METHODS: In 34 patients, 24-h ambulatory BP (A\&D TM2421) was measured at baseline and every 4 months for 1 year or until the need for renal replacement therapy. For each BP recording patients were classified as dippers or non-dippers based on the presence or absence of a nighttime reduction in both systolic and diastolic BP > 10\%. Antihypertensive treatment aimed at an office BP < 120/80 mmHg. GFR was measured by the plasma clearance of (51)Cr-EDTA and albuminuria was determined from 24-h collections. RESULTS: A total of 125 24-h BP recordings were made. Ten patients were constant dippers and five were constant non-dippers throughout the study whereas nineteen patients changed dipping status apparently at random. When analysing pairs of sequential recordings in the individual patient, non-dipper and dipper status remained unaltered in 25 (27\%) and 32 (35\%) of comparisons, respectively, whereas it was inconsistent in 34 (38\%) of cases. No correlation between dipper status and GFR, decline in renal function, degree of albuminuria or BP level could be demonstrated. CONCLUSIONS: The consistency of circadian BP variation seems to be poor in CKD stages 3-5 and single measurements of 24-h ambulatory BP are therefore probably inadequate for the evaluation of dipping status.}, address = {1Department of Nephrology, Rigshospitalet, University of Copenhagen, Denmark.}, author = {Elung-Jensen, Thomas and Strandgaard, Svend and Kamper, Anne-Lise L. }, citeulike-article-id = {2959181}, issn = {1460-2385}, journal = {Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association}, keywords = {bp, ckd, diurnal}, month = {March}, posted-at = {2008-07-03 14:15:07}, priority = {2}, title = {Longitudinal observations on circadian blood pressure variation in chronic kidney disease stages 3-5.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/18353888}, year = {2008} }

TY - JOUR ID - citeulike:2959181 L3 - citeulike-article-id:2959181 TI - Longitudinal observations on circadian blood pressure variation in chronic kidney disease stages 3-5. JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association AD - 1Department of Nephrology, Rigshospitalet, University of Copenhagen, Denmark. SN - 1460-2385 N2 - BACKGROUND: It has been suggested that status as a 'non-dipper' determined from 24-h blood pressure (BP) recordings is associated with increased risk of end-organ damage but little is known about the consistency of dipper status in renal patients. The present post hoc analysis evaluated dipper/non-dipper status prospectively in a study on dosage of enalapril in progressive chronic kidney disease (CKD) stages 3-5. METHODS: In 34 patients, 24-h ambulatory BP (A&D TM2421) was measured at baseline and every 4 months for 1 year or until the need for renal replacement therapy. For each BP recording patients were classified as dippers or non-dippers based on the presence or absence of a nighttime reduction in both systolic and diastolic BP > 10%. Antihypertensive treatment aimed at an office BP < 120/80 mmHg. GFR was measured by the plasma clearance of (51)Cr-EDTA and albuminuria was determined from 24-h collections. RESULTS: A total of 125 24-h BP recordings were made. Ten patients were constant dippers and five were constant non-dippers throughout the study whereas nineteen patients changed dipping status apparently at random. When analysing pairs of sequential recordings in the individual patient, non-dipper and dipper status remained unaltered in 25 (27%) and 32 (35%) of comparisons, respectively, whereas it was inconsistent in 34 (38%) of cases. No correlation between dipper status and GFR, decline in renal function, degree of albuminuria or BP level could be demonstrated. CONCLUSIONS: The consistency of circadian BP variation seems to be poor in CKD stages 3-5 and single measurements of 24-h ambulatory BP are therefore probably inadequate for the evaluation of dipping status. KW - bp KW - ckd KW - diurnal AU - Elung-Jensen, Thomas AU - Strandgaard, Svend AU - Kamper, Anne-Lise PY - 2008/03/19/ UR - http://view.ncbi.nlm.nih.gov/pubmed/18353888 ER -