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Abstract: FR-PO371

Non-Dipping Blood Pressure Profile Does Not Predict a Risk for Developing CKD in Normotensives

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Ida, Tomoharu, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Kusaba, Tetsuro, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Tamagaki, Keiichi, Kyoto Prefectural University of Medicine, Kyoto, Japan
Background

Lack of nocturnal blood pressure (BP) fall (non-dipper), a potent risk of future kidney dysfunction, is frequently observed in chronic kidney disease (CKD) patients. However, whether non-dipping pattern of BP profile in normotensive CKD patients is still a risk for progression of kidney disease is unknown. The aim of our retrospective cohort study is to elucidate the impact of non-dipping BP profile with normotensives on the incidence of ESRD and the CKD progression.

Methods

1198 CKD patients (age:68.6 ± 12.0 , eGFR:33.1 ± 18.2 ml/min/1.73m2, avg ± SD) who underwent ambulatory BP monitoring (ABPM) were enrolled into our analysis. According to their nocturnal BP dipping pattern (>10%: dipper or <10%: non-dipper) and the average 24hr BP (>130/80 mmHg: hypertensive or <130/80 mmHg: normotensive), the patients were divided into 4 groups. Primary composite outcomes including 40% reduction of eGFR from baseline or reaching ESRD were assessed. We also performed the multivariate regression analysis of the factors considered to have significant relationship for the incidence of primary outcomes.

Results

86.3% of patients were non-dipper and half of them were normotensive. The average observation period was 4.76 ± 2.75 (avg ± SD) years. Overall, the composite outcomes occurred in 45.6% of patients and it was highest in hypertensive non-dipper group (60.0%). In normotensive patients, there was no difference in the incidence of primary outcome between non-dipper (32.0%) and dipper (29.6%). Multivariate regression analysis showed that amount of urinary protein (95% CI 0.74-0.91) and 24hr BP (95% CI 0.67-0.81), not BP dipping rate (95% CI 0.98-1.01), were relevant for the incidence of primary outcomes.

Conclusion

ABPM based analysis demonstrated that non-dipping pattern of BP does not predict the risk for the kidney disease progression in normotensive CKD patients.