title: Nocturnal and Circadian Rhythm of Blood Pressure Is Associated with Renal Structure Damage and Function in Patients with IgAN.
abstract: OBJECTIVE
  Abnormal circadian rhythm of blood pressure (BP) is closely related to target organ damage in hypertension. However, the association between abnormal circadian rhythm of BP and renal injury is not clear. We investigated whether renal injury is associated with nocturnal BP and circadian rhythm of BP in Chinese IgAN patients.
  
  
  METHODS
  Clinic and 24 h ambulatory BP monitoring data were obtained from 330 Chinese IgAN patients with mean 24 h BP < 130/80 and mean daytime BP < 135/85 mmHg. Renal histopathological injury was determined according to the Oxford classification of IgAN.
  
  
  RESULTS
  Among the 330 IgAN subjects, 35.8% suffered from nocturnal hypertension, 61.5% had abnormal circadian BP, and 27% had nocturnal hypertension with a nondipping pattern. Compared with nocturnal normotensive patients, patients with nocturnal hypertension had significantly higher levels of blood cystatin C, blood uric acid, and lower estimated glomerular filtration rate (eGFR), and significantly a higher mean renal tissue injury score. The nondipping hypertensive group had significantly higher nocturnal diastolic and systolic BP, blood uric acid, and glomerulosclerosis rates, whereas eGFR was lower. In nondipping hypertensive patients, urinary sodium excretion and renal tissue injury scores were significantly higher than dipping patients. Nocturnal hypertension and abnormal circadian BP correlated with renal tissue injury, renal interstitial fibrosis, and aortic arch atherosclerosis.
  
  
  CONCLUSIONS
  Abnormal circadian rhythm of BP and nocturnal hypertension are common clinical manifestations in Chinese IgAN patients with normal mean 24 h BP. Abnormal circadian BP and nocturnal hypertension may accelerate IgAN progression by inducing renal dysfunction and histopathological damage.
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Lirong
authors.initials: L
authors.lastname: Lin
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Huhai
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Jurong
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Kailong
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Bengang
authors.initials: B
authors.lastname: Huo
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Huanzi
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Tan
authors.affiliation: Department of Nephrology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, PR China. Electronic address: heynmail@yahoo.com.
authors.forename: Yani
authors.initials: Y
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D001013:Aorta, Thoracic / Q000473:pathology; D044466:Asian People; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002681:China; D002940:Circadian Rhythm; D055316:Cystatin C / Q000097:blood; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000652:urine; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D055316:Cystatin C; D014527:Uric Acid; D012964:Sodium
keywords: Circadian rhythm; Immunoglobulin-A nephropathy; Nocturnal blood pressure