title: Chronotherapy for hypertension in patients with chronic kidney disease: a systematic review and meta-analysis in non-black patients.
abstract: OBJECTIVE
  To investigate the effects of chronotherapy on blood pressure in patients with chronic kidney disease (CKD).
  
  
  METHODS
  We searched PUBMED, EMBASE, ASN-ONLINE, the Cochrane Library and the reference articles of published papers without language restriction, for randomized and non-randomized trials that assessed the effect of chronotherapy versus morning dosing regimen drug therapy for CKD patients with hypertension. Meta-analysis was done with random-effect models.
  
  
  RESULTS
  After application of inclusion/exclusion criteria, three randomized controlled trials including 3380 patients were analyzed. Compared with morning dosing regimen drug therapy, chronotherapy was associated with a significant decrease of 3.55% in sleep-time relative decline of systolic blood pressure (SBP) (mean difference [MD], 95% CI, [0.22, 6.88]). In the chronotherapy group, we noted a significant decrease in nocturnal SBP (MD -3.79 mmHg, 95% CI, [-7.18, -0.41]) and nocturnal diastolic blood pressure (MD -1.55 mmHg, 95% CI. [- 2.28, -0.82]), but there was a small increase in awake SBP by 1.19 mmHg (MD, 95% CI, [0.06, 2.31]). No significant difference was noted in all-cause mortality and cardiovascular mortality.
  
  
  CONCLUSIONS
  This meta-analysis suggests that chronotherapy could reduce nocturnal BP in hypertensive CKD patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
authors.forename: Caixia
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xilian
authors.initials: X
authors.lastname: Qiu
authors.affiliation: Operation Room, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Linsheng
authors.initials: L
authors.lastname: Lv
authors.affiliation: Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Huang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
authors.forename: Shaomin
authors.initials: S
authors.lastname: Li
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. lou.tq@163.com.
authors.forename: Tanqi
authors.initials: T
authors.lastname: Lou
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. naturestyle@163.com.
authors.forename: Xun
authors.initials: X
authors.lastname: Liu
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002423:Cause of Death; D003971:Diastole; D055870:Drug Chronotherapy; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D013599:Systole
chemical_list: D000959:Antihypertensive Agents
keywords: Blood pressure patterns; Chronic kidney disease; Chronotherapy; Hypertension; Meta-analysis