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Published on: July 19, 2018
[Blood pressure variation of hypertensive diabetic nephropathy patients undergoing peritoneal dialysis]
Hui Zhong1, Fang Liu, Zhao-hui Sha
1Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China.
Insights
Hypertensive patients with diabetic nephropathy undergoing continuous ambulatory peritoneal dialysis (CAPD) exhibit greater blood pressure variability compared to those with chronic glomerular nephritis, even with similar blood pressure control.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Context:
- Hypertension and diabetes are common comorbidities in patients undergoing chronic peritoneal dialysis.
- Diabetic nephropathy and chronic glomerular nephritis are leading causes of end-stage renal disease.
- Blood pressure variability is an independent risk factor for cardiovascular events.
Purpose:
- To compare blood pressure variability in hypertensive patients with diabetic nephropathy versus chronic glomerular nephritis undergoing continuous ambulatory peritoneal dialysis (CAPD).
Summary:
- This study compared 24-hour ambulatory blood pressure monitoring (ABPM) parameters in hypertensive diabetic nephropathy (DN-PD) and chronic glomerular nephritis (CGN-PD) patients on CAPD.
- While average blood pressures were similar, the DN-PD group showed significantly higher systolic blood pressure variability (SBPV) and coefficient of variation (SBPCV) during 24-hour and daytime periods.
- No significant differences were observed in diastolic blood pressure variability between the groups.
Impact:
- Hypertensive diabetic nephropathy patients on CAPD experience greater blood pressure fluctuations, suggesting a potential increased cardiovascular risk despite comparable blood pressure control.
- These findings highlight the importance of monitoring blood pressure variability in this specific patient population.
- Further research may explore targeted interventions to manage blood pressure variability in DN-PD patients.
Objective:
To investigate the variance of blood pressure of hypertensive diabetic patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
Methods:
Twenty hypertensive CAPD patients older than 40 years with diabetic nephropathy (DN-PD group) and twenty patients with chronic glomerular nephritis (CGN-PD group) were recruited. Peritoneal status and dialysis adequacy of the patients in the two groups were calculated using PD Adequest. All patients were given 24-hour ambulatory blood pressure monitoring (ABPM). Parameters of blood pressure variation were calculated and compared between the two groups, which included 24 h systolic and diastolic blood pressure variability (24 h SBPV/DBPV) and coefficient of variation (24 h SBPCV/24 h DBPCV), daytime systolic anid diastolic blood pressure variability (dSBPV/ DBPV) and coefficient of variation (dSBPCV/dDBPCV), and night time systolic and diastolic blood pressure variability (nSBPV/ DBPV) and coefficient of variation (nSBPCV/nDBPCV).
Results:
No significant differences in clinical characteristics were found between the two groups of patients except for fast glucose. No significant differences in average systolic and diastolic blood pressures, average piulse pressure and mean 24 h, daytime, and nighttime arterial pressures were found between the two groups. However, the DN-PD group had significantly higher 24 h SBPV, 24 h SBPCV, dSBPV and dSBPCV than the CGN-PD group (P < 0.05).
Conclusion:
Hypertensive diabetic nephropathy patients undergoing peritoneal dialysis have greater blood pressure variance than those with hypertensive chronic glomerular nephritis, despite a similar result of blood pressure control.
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