Kidney Week

Abstract: SA-PO0502

Absence of Nocturnal Systolic Blood Pressure Dipping Is Associated with Impaired Cognitive Function in Patients with Stages 3-4 CKD

Session Information

• CKD: Clinical - Therapies, CKM Health, Special Populations, and More
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Buffington, Tyler Matthew, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Tyler Matthew Buffington

• Nowak, Kristen L., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Kristen L. Nowak, PhD, MPH

• Chonchol, Michel, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Michel Chonchol, MD, FASN

• Lapierre-Nguyen, Stephanie, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Stephanie Lapierre-Nguyen, PhD

Background

Patients with chronic kidney disease (CKD) often have elevated systolic blood pressure (SBP) and overactivation of the sympathetic nervous system. Increasing evidence suggests that elevated SBP, specifically at night, may be associated with impairments in cognitive function. Dippers refer to individuals whose SBP decreases during nocturnal hours, and non-dippers are individuals without a dip in SBP during the night, as compared to diurnal SBP. The purpose of this study was to examine the association between blood pressure dipping/non-dipping with cognitive function in patients with CKD.

Methods

A 24-hour ambulatory blood pressure monitor collected readings every 20 minutes. Patients were grouped into dippers (ratio <0.9) and non-dippers (ratio ≥0.9) using the ratio of diurnal SBP to nocturnal SBP (nocturnal SBP average/ daytime SBP average *100). Cognitive function was measured using the NIH toolbox V2 cognitive assessment. A total composite score (TCS) was calculated based on toolbox tests assessing executive function, working and episodic memory, processing speed, receptive vocabulary, and expressive language and compared between dippers and non-dippers (independent samples t-test). Pearson’s bivariate correlation was used to evaluate the association between cognitive function and nocturnal SBP, as well as daytime and resting SBP.

Results

33 patients with stage 3-4 CKD (71+7 years; 64% male; BMI: 29.0+4.6; eGFR: 41.0+9.6 mL/min/1.73 m²; seated resting SBP: 120+15 mmHg) were included. Fourteen patients were classified as dippers, nineteen were classified as non-dippers. Age, sex, BMI, eGFR, and seated resting SBP were not significantly different between groups (p≥0.3). TCS was significantly lower in non-dippers (95 +8) vs. dippers (102+7, p = 0.018). Nocturnal SBP was inversely correlated with TCS (r=-0.52, p=0.002). Interestingly, there was no association of daytime SBP or seated resting SBP with TCS (p≥0.09).

Conclusion

Our results suggest an association of non-dipping in CKD patients and elevated nighttime SBP with impaired cognitive function. These findings prompt further investigation into the mechanism of how nighttime blood pressure may influence cognitive function in patients with CKD.

Acknowledgment

This work was supported by NIH NIDDK and the American Society of Nephrology.

Funding

• NIDDK Support