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Kidney Week

Abstract: TH-PO939

Characteristics of 24-Hour Ambulatory Blood Pressure in Non-Dialysis Patients with Diabetic Kidney Disease

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Chen, Xiaoqiu, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
  • Song, Shicong, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
  • Deng, Qiongxia, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
  • Wen, Ruowei, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
  • Wang, Cheng, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
Background

Data about characteristics of 24-hour ambulatory blood pressure in non-dialysis patients with diabetic kidney disease was limited.

Methods

We monitored 24-hour ambulatory blood pressure in non-dialysis patients with diabetic kidney disease from the nephrology division, the fifth affiliated hospital of Sun Yat-Sen University from August 2000 to October 2018, and compared with primary chronic glomerulonephritis patients matching in age(±5 years old), sex and CKD stages. The target organ damages were measured by carotid intima-media thickness, left ventricular hypertrophy, diastolic dysfunction, eGFR<60ml/min and massive proteinuria. Blood pressure loads, circadian rhythm and target organ damages in two groups were evaluated and compared. Multivariate logistic analyses were used to evaluated the relationship between blood pressure loads and target organ damage parameters.

Results

202 patients with diabetic kidney disease were enrolled in this study. The mean age of the patients was 57±9 years and 66.3%(134/203)were men. Compared with control patients, patients with diabetic kidney disease had a higher level of systolic blood pressure in clinic, daytime, nighttime or 24-hour ambulatory measurement. They also had a higher proportion in reversed dippers(34.2% vs. 24.8%,P=0.038) and target organ damage evaluations, like the carotid intima-media thickness(69.3% vs. 26.2%,P<0.001), left ventricular hypertrophy(63.4% vs. 50.0%,P=0.009), diastolic dysfunction(74.3% vs. 46.0%,P<0.001) and massive proteinuria(51.0% vs. 25.7%,P<0.001).Multivariate logistic analyses, which included both clinic and ambulatory blood pressure, showed that only 24-hour systolic blood pressure independently predicted significantly the target organ damage.

Conclusion

Patients with diabetic kidney disease had a higher systolic blood pressure loads, a higher percentage of reversed dippers and a more severe target organ damage. 24-hour systolic blood pressure was independently associated with target organ damage.