Ambulatory blood pressure characteristics in hypertensive patients with "hyperfiltration" renal damage
Kuang Zemin
Feng Shujun
Wang Ying
Yu Zhenqiu
Hu Hongjuan
Abstract：Objective To analyze characteristics of ambulatory blood pressure in hypertensive patients with "hyperfiltration" renal damage.Methods Totally 376 patients who were diagnosed of hypertension in Beijing Anzhen Hospital,Capital Medical University from November 2011 to May 2013 were retrospectively analyzed.They were divided into hyperfiltration group according to glomerular filtration rate (eGFR) [102 cases,eGFR ≥ 120 ml/(min · 1.73 m2)] and normal group [274 cases,90 ml/(min · 1.73 m2) ≤ eGFR ＜ 120 ml/(min · 1.73 m2)].According to the level of urine albumin/creatinine rate(UACR),the hyperfiltration group were divided into group A1(19 cases,UACR≤10 mg/g),group A2(21 cases,10 mg/g ＜ UACR≤20 mg/g).,group A3(28 cases,20 mg/g ＜ UACR≤30 mg/g) and group A4(34 cases,30 mg/g ＜ UACR ＜ 300 mg/g);the normal group was divided into group B1 (45 cases,UACR≤10 mg/g),group B2(69 cases,10 mg/g ＜ UACR≤20 mg/g),group B3(64 cases,20 mg/g ＜ UACR≤30 mg/g) and group B4(96 cases,30 mg/g ＜ UACR ＜300 mg/g).Ambulatory blood pressure characteristics were analyzed among groups.Results In patients with normal eGFR,nocturnal systolic blood pressure(nSBP) and nocturnal diastolic blood pressure(nDBP) in group B4 were significantly higher than those in group B1 (P ＜ O.05).In hyperfihration group,nSBP and nDBP in group A4 were significantly higher than those in group A1 (P ＜ 0.05).The level of nDBP in group A4 was significantly higher than that in group B4 [(93 ± 10) mmHg vs (82 ± 11) mmHg] (P ＜ 0.05).In patients with normal eGFR,ASBP and ADBP in group B4 were significantly lower than those in group B1;the proportion of abnormal blood pressure circadian rhythm in group B4 was significantly higher than that in group B1,B2,B3 [91.7％ (88/96) vs 42.2％ (27/64),34.8％ (24/69),8.9％ (4/45)] (P ＜0.05).In hyperfiltration group,ASBP and ADBP in group A4 were significantly lower than those in group A1;the proportion of abnormal blood pressure circadian rhythm in group A4 was significantly higher than that in group A1,A2,A3[94.1％ (32/34) vs 35.7％ (10/38),23.8％ (5/21),15.8％ (3/19)] (.P ＜ 0.05).Conclusions Nocturnal blood pressure elevation and abnormal circadian rhythm that occur in hypertensive patients can develop into "hyperfiltration" stage,whereas UACR is still within the normal range.It is suggested that combined monitoring of blood pressure circadian rhythm and nocturnal blood pressure should be applied in assessment and intervention of "hyperfiltration" renal dysfunction along with eGFR.
Keywords：HypertensionRenal damageHyperfiltrationAmbulatory blo9d pressure monitoring
Publication Date：2017-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1301-1305 )