title: Morning Blood Pressure Surge as a Predictor of Development of Chronic Kidney Disease.
abstract: Blood pressure (BP) usually increases upon awakening--a physiological mechanism called morning BP surge (MBPS). BP values above the MBPS threshold are associated with target organ damage, including left ventricular hypertrophy and proteinuria. Despite these data, there have been no studies that have investigated the association between elevated MBPS and the development of incident chronic kidney disease (CKD). In this study, patients with essential hypertension were included and underwent ambulatory BP measurements and MBPS. Patients were followed for a median of 3.33 years. In total, 622 patients were enrolled. The mean age of patients was 57.6±12.4 years, 54.0% were men, 16.7% had diabetes, and 10.6% had prevalent cardiovascular disease. During follow-up, 32 patients developed CKD. Higher MBPS, analyzed both as continuous and categorical variables, was associated with incident CKD in all models. Elevated MBPS is associated with kidney function deterioration and the development of CKD. Studies are needed to further examine underlying mechanisms regarding MBPS and these renal outcomes.
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Turak
authors.affiliation: Department of Nephrology, Numune State Hospital, Konya, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Afsar
authors.affiliation: Nephrology Clinic, Dialysis and Renal Transplant Center, "C.I. PARHON" University Hospital, and "Grigore T. Popa" University of Medicine, Iasi, Romania.
authors.forename: Dimitrie
authors.initials: D
authors.lastname: Siriopol
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Firat
authors.initials: F
authors.lastname: Ozcan
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Kumral
authors.initials: K
authors.lastname: Cagli
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Cagri
authors.initials: C
authors.lastname: Yayla
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Oksuz
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Mendi
authors.affiliation: Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.affiliation: Nephrology Clinic, Dialysis and Renal Transplant Center, "C.I. PARHON" University Hospital, and "Grigore T. Popa" University of Medicine, Iasi, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.affiliation: Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D002940:Circadian Rhythm; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors