The influence factors of blood pressure circadian rhythm in peritoneal dialysis patients and its relationship with residual renal function and cardiac function

Abstract

Objective Observed the characteristics and influence factors of blood pressure circadian rhythm in continuous ambulatory peritoneal dialysis patients. To investigate the effect of residual renal function and cardiac function. Methods Prospectively collected 120 cases of continuous ambulatory peritoneal dialysis from June 2016 to March 2017 in Tangshan renal medicine dialysis centers, who combined with hypertension were treated with peritoneal dialysis for more than 3 months. According to the dynamic monitoring blood pressure circadian rhythm of blood pressure, 120 cases were divided into the normal rhythm of blood pressure and the abnormal blood pressure rhythm group. Collected medical history; Tested related test index respectively; Cardiac ultrasound. According to the formula to calculate residual renal function, left ventricular mass index, Eingabe/Ausgabe, Ejection Fraction. Univariate and multivariate unconditional logistic regression analysis was used to analyze the risk factors of circadian rhythm of blood pressure. Stepwise multiple linear regression analysis was used to analyze the risk factors of residual renal function and cardiac function. Results CAPD patients with normal blood pressure rhythm in 14 cases(11.7%), abnormal blood pressure rhythm in 106 cases (88.3%) , Among them, non dipper blood pressure accounted for 75 cases(62.5%). Single factor and multiple factors unconditioned logistic regression analysis revealed that after the comparison of gender and age, Risk factors for abnormal circadian rhythm of blood pressure were: UA(OR=1.197, 95%CI: 1.099-1.441), CRP(OR=1.170, 95%CI: 1.061-1.331), RRF(OR=1.389, 95%CI: 1.160-1.779). Using stepwise multiple linear regression analysis of dangerous factors affecting residual renal function and cardiac function, we found: Residual renal function negatively correlated with left ventricular myocardial mass index, systolic blood pressure drops at night rate, and ultrafiltration volume; LVMI (cardiac function) Positively correlated with 24 h average systolic blood pressure, and negatively correlated with systolic blood pressure drop ratio and residual renal function at night. Abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function. Conclusions UA, CRP and RRF may affect the CAPD patients blood pressure circadian rhythm. At the same time, abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function. Therefore, pay attention to the monitoring and control of ABPM, can better protect the residual renal function and improve cardiac function, so as to prolong and improve the survival time and quality of life of patients with CAPD. Key words: Peritoneal dialysis; Blood pressure monitoring, ambulatory; CKD; Blood pressure circadian rhythm