Diurnal blood pressure variations in incipient and end stage diabetic renal disease.
Our aim was to compare the diurnal blood pressure patterns of people with Type 1 diabetes on continuous ambulatory peritoneal dialysis (CAPD, n=9) or haemodialysis (n=10) to diabetic patients with normo-albuminuria (n=12) or micro-albuminuria (n=15). Blood pressure was measured with an ABPM02 Meditech oscillometric blood pressure monitor. The micro-albuminuric group had significantly higher nocturnal diastolic and mean arterial pressures than the normo-albuminuric group. CAPD and haemodialysis patients had significantly higher day time, nocturnal mean systolic, diastolic and mean arterial blood pressures. Micro-albuminuric and end-stage renal failure patients displayed a loss of the physiological drop of systolic blood pressure, which was only significant in the normo-albuminuric group. Nocturnal drop of blood pressure characterised by diurnal indices were 7.4% in the CAPD, 8.8% in the haemodialysis, 10.0% in the micro-albuminuric and 16.5% in the normo-albuminuric group. These results suggest, that pathological circadian blood pressure variation is common in diabetic patients on dialysis, and ambulatory blood pressure monitoring can be a useful tool both in its the detection and its adequate treatment.
Tóth
L
L
Second Department of Medicine, Szent István Hospital, II. Belgyógyászat, Nagyvárad tér 1, 1096, Budapest, Hungary.
Vörös
P
P
Lengyel
Z
Z
Liptai
M
M
Németh
C
C
Kammerer
L
L
D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D001806:Blood Urea Nitrogen; D002096:C-Peptide / Q000097:blood; D002784:Cholesterol / Q000097:blood; D002940:Circadian Rhythm; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D014280:Triglycerides / Q000097:blood; D001613:beta 2-Microglobulin / Q000097:blood / Q000652:urine
D001786:Blood Glucose; D002096:C-Peptide; D002784:Cholesterol; D003404:Creatinine; D006442:Glycated Hemoglobin; D014280:Triglycerides; D001613:beta 2-Microglobulin