Ambulatory blood pressure in type 2 diabetic patients with albuminuria: Relation to the renal function and structural lesions

Abstract

Background/aims To investigate possible relationships between ambulatory blood pressure (BP) and renal structure and function in type 2 diabetic patients. Methods Renal biopsies were performed on 39 patients with urine albumin concentrations above 100 mg/l. BP was investigated with a 24-h, automated, portable BP device. Results None of the patients in the study had signs of other renal disease than nephrosclerosis or diabetic nephropathy. Ten patients had slight, 13 intermediate, and 6 severe diabetic nephropathy on the renal biopsy. Among the remaining patients, 4 had normal microscopy findings and 6 had nephrosclerosis. The degree of albuminuria correlated to the systolic BP during the day ( r=.43; P<.01) and night ( r=.49; P<.01). The glomerular filtration rate (GFR) was associated with the systolic BP daytime ( r=−.32; P<.05) and nighttime ( r=−.47; P<.01). Neither degree of albuminuria nor GFR was associated with the diastolic BP levels. The degree of the glomerular pathology correlated to the systolic BP during daytime ( P<.05), whereas the degree of interstitial fibrosis did not correlate to the BP levels. Conclusions We have demonstrated that degree of albuminuria and GFR was significantly associated with daytime and nocturnal BP and glomerular structure with daytime BP. Furthermore, no renal disease other than diabetic nephropathy was found.