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Abstract: FR-PO1088

Masked Hypertensive Disorders Are Prevalent in Active Lupus Nephritis Patients

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Trujeque, Mariedel, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico
  • López hernández, Yesser Joel, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico
  • Santander, Jesus Ivan, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico
  • Morales-Buenrostro, Luis E., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico
  • Mejia-Vilet, Juan M., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico
Background

SLE patients have an increased cardiovascular mortality. In CKD, 24h-ABPM studies demonstrate a high-prevalence of masked hypertensive disorders.

Methods

From March 2016 to April 2018, 58 active lupus nephritis patients were evaluated by 24h-BP monitoring the day of the renal biopsy procedure. Two validated oscillometric-based devices were used (Spacelabs 91207 and Welch Allyn 6100). A registry was considered appropriate if >20 daytime and >7 nighttime measurements were available. For analysis, patients were divided into those with or without previous hypertension.

Results

Out of 58 LN patients, 17 (29%) had a previous hypertension dx. These patients were older, had higher in-clinic BP and their renal biopsy showed higher interstitial fibrosis/tubular atrophy. In the 24h-BPM, patients with previous HT had higher overall, daytime and nocturnal BP. However, the nocturnal decrease of BP was diminished and not different between groups. Only 11 (19%) patients had normal dipping, in 30 (52%) it was decreased, and in 17 (29%) was absent. White-coat hypertension (WCH) was found in 3/11 (27%) in-clinic HT and masked uncontrolled hypertension in 3/6 (50%) of in-clinic controlled patients. In the non-previous HT group, WCH was found in 4/11 (36%) of in-office HT patients and masked hypertension in 12/30 (40%) of in-office controlled patients. The nighttime systolic and diastolic BP were more frequently abnormal compared to daytime measurements.

Conclusion

Masked hypertensive disorders are frequent in lupus nephritis patients. As BP thresholds are part of an appropriate management of proteinuric diseases, 24h blood pressure measurements should be considered in clinical practice. These studies were made as inpatients and should be corroborated with ambulatory measurements.