title: Effect of valsartan with bedtime dosing on chronic kidney disease patients with nondipping blood pressure pattern.
abstract: Nondipping blood pressure (BP) pattern is a potential independent risk factor for chronic kidney disease (CKD). Bedtime administration of valsartan is considered to normalize circadian rhythm and protect the kidneys and heart in CKD patients. However, more clinical trials are needed to confirm this benefit. Sixty patients with nondipping BP pattern and thirty patients with dipping BP pattern were enrolled in this study, and the patients with nondipping BP pattern were randomly divided into two groups and treated with bedtime or awakening doses of valsartan (80-320 mg). Nondipping BP patients treated with bedtime doses of valsartan showed a greater reduction in 24-hour proteinuria and bedtime proteinuria, a greater delayed decline in estimated glomerular filtration rate, and more protection against myocardial hypertrophy (P<.05) compared with patients with the nondipping BP pattern treated with the awakening dose (P<.05). This was similar to patients with dipping BP. No severe clinical complications were recorded in these patients. Valsartan with bedtime dosing in CKD patients with the nondipping BP pattern have better renal and cardiovascular protection. Antihypertensive "chronotherapy" may be useful in clinical practice for CKD patients.
authors.affiliation: Division of Nephrology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Xun
authors.initials: X
authors.lastname: Liu
authors.forename: Cui-Cui
authors.initials: CC
authors.lastname: Li
authors.forename: Zeng Chun
authors.initials: ZC
authors.lastname: Ye
authors.forename: Hui
authors.initials: H
authors.lastname: Peng
authors.forename: Zhujiang
authors.initials: Z
authors.lastname: Chen
authors.forename: Tanqi
authors.initials: T
authors.lastname: Lou
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D018660:Blood Pressure Monitoring, Ambulatory; D016009:Chi-Square Distribution; D055870:Drug Chronotherapy; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000068756:Valsartan
chemical_list: D000959:Antihypertensive Agents; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine