Features of ambulatory blood pressure in 808 patients with primary glomerular disease and their correlation with target organ damage

Abstract

Objective To explore the features of ambulatory blood pressure in patients with primary glomerular disease and their correlation with target organ damage (TOD). Methods Patients with primary glomerular disease admitted to the Nephrology Department, the Third Affiliated Hospital of Sun Yat-sen University from May 2010 to May 2015 were enrolled. Ambulatory blood pressure monitoring (ABPM), clinical BP, ultrasonographic assessment and other clinical data were collected. Univariate and multivariate analyses were used to ascertain the relationship between ABPM results and clinical parameters. Results 808 patients were enrolled. Patients turned out to have a higher level of 24-hour systolic blood pressure (SBP), day-time SBP, and night-time SBP as their kidney function declined (rs=0.547, 0.538, 0.546, P<0.01). Compared with that in CKD 1-3, The percentage of dipper blood pressure pattern decreased and that of reversed dipper blood pressure pattern increased in CKD stage 4-5 (P<0.05). A higher level of 24 h SBP was independently associated with kidney function damage (OR=1.069, P<0.01), and a higher level of night-time SBP was an independent factor affecting left ventricular hypertrophy (OR=1.033, P<0.01) and reduction of diastolic function of left ventricle (OR=1.019, P<0.01) after multivariate logistic regression analyses. Conclusion With advancing CKD stage, the level of 24 h SBP, day-time SBP, and night-time SBP was higher and the percentage of reversed dipper blood pressure pattern was higher. The parameters of ABPM were closely related to renal damage and cardiovascular injuries. Key words: Blood pressure monitoring, ambulatory; Hypertension; Kidney glomerulus, primary; Target organ damage