The valuation of the effects of biochemical parameters and 24-h blood pressure circadian rhythm on chronic kidney disease risk in patients with primary hypertension

Abstract

Background The aim of the study was to evaluate biochemical parameters and parameters of blood pressure circadian rhythm from ABPM that predispose to chronic kidney disease in population of patients with primary hypertension.
Material and methods 142 patients with average age of 51 years with primary hypertension were included into the retrospective study. All information about patients were taken from medical documentations, and contained: age, weight, glucose level, total cholesterol, LDL, HDL, triglycerides level and serum creatinine level. Glomerular filtration rate (GFR) was estimated using Modification of Diet in Renal Disease (MDRD) formula. Chronic kidney disease (CKD) was diagnosed in patients with GFRs less than 60 ml/min/1.73 m², other patients were healthy. 24-hour blood pressure from ABPM was analyzed including systolic and diastolic blood pressure, mean arterial pressure (MAP), pulse pressure, and dip. Dippers was defined when MAP dip was at least 10%, and nondippers if less than 10%.
Results Hypertensive patients with coexisting chronic kidney disease were older and had higher glucose level than patients without CKD. Moreover they had hypertriglyceridemia and hypercholesterolemia, although there were no significant differences between both groups. Systolic blood pressure measured with sphygmomanometer and pulse pressure from ABPM were higher at day and night in patients with CKD. More non-dippers were in the group of hypertensive patients with CKD, but it was not significant. There was significant negative correlation between GFR and systolic blood pressure, glucose level, triglycerides level and night-time pulse pressure from ABPM.
Conclusions 1. Significantly higher blood pressure, pulse pressure, higher glucose serum level in the group of patients with hypertension and chronic kidney disease and negative correlation between these parameters and GFR, evidence their role in renal damage in hypertensive patients. 2. Estimation of glucose level, total cholesterol, LDL, HDL, triglycerides levels, systolic blood pressure and pulse pressure are significant and early indicators to identify patients with CKD risk.
Arterial Hypertension 2010, vol. 14, no 2, pages 151-156.