Abstract
Chronic kidney disease (CKD) affects approximately two million people (in a population of 20 million) in Romania. Hypertension is often associated with CKD and both (hypertension and CKD) are risk factors for cardiovascular (CV) events. Ambulatory blood pressure monitoring (ABPM) is increasingly used all around the world for the diagnosis and monitoring of BP (blood pressure) because it is proven that the ABPM is superior to office BP measurements in evaluating patients with hypertension, with or without CKD. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR). Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). It has prognostic value for cardiac death and stroke and several studies have showed that is negatively related to eGFR and is positively related to albuminuria. Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function. These facts suggest that ABPM offers multiple useful data with impact, not only in future CV and renal outcomes assessment, but also in the treatment and management of hypertensive patients with CKD.
Highlights
It is known that kidney disease is the 9th leading cause of death in the United States (1)
This is true for markers of kidney damage, particularily for proteinuria: a cross-sectional study of 232 Chronic kidney disease (CKD) patients pointed out that Ambulatory blood pressure monitoring (ABPM) is more strongly associated with proteinuria than office blood pressure (BP) (15)
A cross-sectional study that involved 10271 hypertensive patients found a large difference between the patients with and without CKD in the prevalence of the riser BP pattern 17.6% vs. 7.1%, which means that CKD is associated with a 2.5 times higher prevalence of the BP pattern associated with the highest CVD risk
Summary
THE PARTICULARITIES OF ABPM PARAMETERS IN HYPERTENSIVE PATIENTS WITH NON-DIALYSIS CKD. Dorin Ionescu[1,2], MD, PhD 1“Carol Davila” University of Medicine and Pharmacy, Bucharest 2Nephrology Department, University Emergency Hospital, Bucharest. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR) Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function These facts suggest that ABPM offers multiple useful data with impact, in future CV and renal outcomes assessment, and in the treatment and management of hypertensive patients with CKD
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