title: Non-dipper status and left ventricular hypertrophy as predictors of incident chronic kidney disease.
abstract: We have hypothesized that non-dipper status and left ventricular hypertrophy (LVH) are associated with the development of chronic kidney disease (CKD) in non-diabetic hypertensive patients. This study included 102 patients with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m(2). Ambulatory blood pressure monitoring and echocardiography were performed at the beginning of the study, and the serum creatinine levels were followed. During the average follow-up period of 51 months, CKD developed in 11 patients. There was a significant difference in the incidence of CKD between dippers and non-dippers (5.0% vs 19.0%, P < 0.05). Compared to patients without CKD, patients with incident CKD had a higher urine albumin/creatinine ratio (52.3 ± 58.6 mg/g vs 17.8 ± 29.3 mg/g, P < 0.01), non-dipper status (72.7% vs 37.4%, P < 0.05), the presence of LVH (27.3% vs 5.5%, P < 0.05), and a lower serum HDL-cholesterol level (41.7 ± 8.3 mg/dL vs 50.4 ± 12.4 mg/dL, P < 0.05). Based on multivariate Cox regression analysis, non-dipper status and the presence of LVH were independent predictors of incident CKD. These findings suggest that non-dipper status and LVH may be the therapeutic targets for preventing the development of CKD in non-diabetic hypertensive patients.
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Hye Rim
authors.initials: HR
authors.lastname: An
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Jung-Hwa
authors.initials: JH
authors.lastname: Ryu
authors.forename: Yong Kyu
authors.initials: YK
authors.lastname: Lee
authors.forename: Mina
authors.initials: M
authors.lastname: Yu
authors.forename: Dong-Ryeol
authors.initials: DR
authors.lastname: Ryu
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Kim
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.forename: Kyu Bok
authors.initials: KB
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D008076:Cholesterol, HDL / Q000097:blood; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis*; D015994:Incidence; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D000418:Albumins; D008076:Cholesterol, HDL; D003404:Creatinine