Central blood pressure and nighttime blood pressure in patients with non-diabetic chronic kidney disease

Introduction. Arterial hypertension is a well-known risk factor of both cardiovascular complications and faster progression of chronic kidney disease (CKD). There is growing evidence that central blood pressure (BP) and nighttime BP may have an advantage in predicting the risk of cardiovascular complications and the progression of CKD in comparison with the traditional office BP measurements. The aim of this study was to evaluate the central BP and nighttime BP in non-diabetic CKD patients with no, or only mild proteinuria i.e. autosomal dominant polycystic kidney disease (ADPKD) or IgA nephropathy (IgAN).

Material and methods. Forty patients with CKD stage 3 or 4 were enrolled into the study. In each patient the measurement of peripheral and central BP was conducted, as well as the assessment of pulse wave velocity (PWV) and the 24-hour blood pressure monitoring (ABPM).

Results. Despite the lower office and central BP values in patients with IgAN in comparison to patients with ADPKD, both studied groups did not differ in the mean BP in the 24-hour abpm. In the entire studied group a significant positive correlation was found between the augmentation pressure and age, as well as between the augmentation index — AIx% and age. Moreover, a significant positive correlation between the decrease of nighttime BP and eGFR was observed. Additionally, a significant positive correlation between PWV and age was found.

Conclusions. 1. Patients with ADPKD and IgAN, despite the differences in office and central BP do not differ in respect of the mean BP in the 24-hour abpm. 2. In both groups of patients vascular stiffness increases with age and deteriorating kidney function. 3. Lower decrease of nighttime blood pressure is related to the worse kidney function in patients with non-diabetic CKD.

Arterial Hypertens. 2017, vol. 21, no. 1, pages: 34–41 DOI: 10.5603/AH.2017.0005