Related Experiment Video

Updated: May 11, 2026

Non-invasive Assessment of Microvascular and Endothelial Function
05:41

Non-invasive Assessment of Microvascular and Endothelial Function

Published on: January 29, 2013

Structural and Functional Capillary Integrity, Arterial Stiffness and Central Hemodynamics in CKD Patients With and

Marieta P Theodorakopoulou1, Fotini Iatridi1, Konstantinos Stavropoulos2

  • 1First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

American Journal of Hypertension
|March 29, 2025
PubMed

Insights

Nocturnal hypertension in chronic kidney disease (CKD) patients is linked to reduced capillary density, indicating impaired microcirculation. This finding highlights nocturnal hypertension as a factor worsening microvascular damage in CKD.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Microcirculation Research

Background:

  • Nocturnal hypertension increases renal and cardiovascular risks in chronic kidney disease (CKD) patients.
  • Endothelial dysfunction and microvascular damage are common in CKD, correlating with disease progression and adverse outcomes.

Purpose of the Study:

  • To compare microcirculatory function and central hemodynamics in CKD patients with and without nocturnal hypertension.
  • To investigate the relationship between nocturnal hypertension and microvascular parameters in CKD.

Main Methods:

  • 96 pre-dialysis CKD patients underwent 24-hour ambulatory blood pressure monitoring (ABPM).
  • Nailfold video-capillaroscopy assessed capillary density at baseline, during post-occlusive reactive hyperemia, and venous congestion.
  • Central hemodynamics and arterial stiffness were measured using Sphygmocor.

Main Results:

  • CKD patients with nocturnal hypertension showed significantly lower capillary density at baseline, during reactive hyperemia, and venous congestion compared to normotensive CKD patients.
  • Nocturnal hypertension was associated with higher aortic blood pressure but not other arterial stiffness parameters.
  • These microvascular differences were more pronounced in diabetic CKD patients.

Conclusions:

  • Lower capillary density during hyperemia and congestion in nocturnal hypertensive CKD patients suggests impaired capillary recruitment.
  • Nocturnal hypertension exacerbates the microvascular dysfunction already present in CKD.
  • These findings underscore the clinical importance of monitoring and managing nocturnal blood pressure in CKD.
Abstract

Keywords:
blood pressurecapillary rarefactionchronic kidney diseasemicrocirculationnocturnal hypertensionvascular dysfunction

More Related Videos

Assessment of Vascular Function in Patients With Chronic Kidney Disease08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

A Murine Model of Hemodialysis Access-Related Hand Dysfunction08:39

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...