open access

Vol 15, No 2 (2022)
Research paper
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Circadian blood pressure profile in non-dialyzed patients with chronic kidney disease

Paweł Stróżecki1, Zbigniew Włodarczyk2
DOI: 10.5603/RDTF.2022.0006
·
Renal Disease and Transplantation Forum 2022;15(2):80-86.
Affiliations
  1. Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum im. L. Rydygier in Bydgoszcz of the Nicolaus Copernicus University in Toruń
  2. Department of Transplantology and General Surgery, Collegium Medicum im. L. Rydygier in Bydgoszcz of the Nicolaus Copernicus University in Toruń

open access

Vol 15, No 2 (2022)
Review articles

Abstract

Blood pressure follows a circadian rhythm; its physiological levels are higher during the day and lower at night. Ambulatory blood pressure monitoring (ABPM) facilitates the analysis of circadian blood pressure profiles and the diagnosis of nocturnal hypertension. Circadian blood pressure profiles are classified into 4 types: normal "dipper" profile with blood pressure falling by >10% and ≤20%, "extreme dipper" profile with an excessive blood pressure fall (> 20%), "non-dipper" profile with reduced (≥10%) nocturnal blood pressure fall, and "reverse dipper" profile characterized by nocturnal blood pressure rise. Nocturnal hypertension is diagnosed for nocturnal systolic blood pressure of ³120 mmHg or diastolic blood pressure of ≥70 mmHg. Abnormal circadian blood pressure profiles are observed in the majority of chronic kidney disease (CKD) patients not undergoing dialysis, as well as in the vast majority of kidney transplant recipients. Reduced nocturnal blood pressure dips, particularly in the “reverse dipper” profile, and nocturnal hypertension are associated with more severe hypertension-mediated organ damage, an increased cardiovascular risk, and faster progression of CKD. Hence, more extensive ABPM is required in CKD to identify patients at high risk of complications. Further studies are also required to assess the influence of different therapeutic strategies on the circadian blood pressure profile in CKD patients.

Abstract

Blood pressure follows a circadian rhythm; its physiological levels are higher during the day and lower at night. Ambulatory blood pressure monitoring (ABPM) facilitates the analysis of circadian blood pressure profiles and the diagnosis of nocturnal hypertension. Circadian blood pressure profiles are classified into 4 types: normal "dipper" profile with blood pressure falling by >10% and ≤20%, "extreme dipper" profile with an excessive blood pressure fall (> 20%), "non-dipper" profile with reduced (≥10%) nocturnal blood pressure fall, and "reverse dipper" profile characterized by nocturnal blood pressure rise. Nocturnal hypertension is diagnosed for nocturnal systolic blood pressure of ³120 mmHg or diastolic blood pressure of ≥70 mmHg. Abnormal circadian blood pressure profiles are observed in the majority of chronic kidney disease (CKD) patients not undergoing dialysis, as well as in the vast majority of kidney transplant recipients. Reduced nocturnal blood pressure dips, particularly in the “reverse dipper” profile, and nocturnal hypertension are associated with more severe hypertension-mediated organ damage, an increased cardiovascular risk, and faster progression of CKD. Hence, more extensive ABPM is required in CKD to identify patients at high risk of complications. Further studies are also required to assess the influence of different therapeutic strategies on the circadian blood pressure profile in CKD patients.

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Keywords

ambulatory blood pressure monitoring, circadian blood pressure profile, chronic kidney disease

About this article
Title

Circadian blood pressure profile in non-dialyzed patients with chronic kidney disease

Journal

Renal Disease and Transplantation Forum

Issue

Vol 15, No 2 (2022)

Article type

Research paper

Pages

80-86

Page views

328

Article views/downloads

33

DOI

10.5603/RDTF.2022.0006

Bibliographic record

Renal Disease and Transplantation Forum 2022;15(2):80-86.

Keywords

ambulatory blood pressure monitoring
circadian blood pressure profile
chronic kidney disease

Authors

Paweł Stróżecki
Zbigniew Włodarczyk

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