title: Circadian blood pressure abnormalities in patients with primary nephrotic syndrome.
abstract: BACKGROUND
  Only a few studies have evaluated the abnormalities of ambulatory blood pressure (ABP) in patients with nephrotic syndrome (NS).
  
  
  METHODS
  The 24-h ABPs were measured in primary NS patients with acute onset of disease and analyzed in relation to the clinical variables.
  
  
  RESULTS
  Our subjects comprised 21 patients: 17 with minimal change disease and 4 with focal segmental glomerulosclerosis. Of these patients, 8 (38%) had daytime hypertension, 13 (62%) had nighttime hypertension, and 13 (62%) were non-dippers (nighttime-to-daytime ratio of ABP: NDR > 0.9). The serum sodium level was correlated with the average 24-h ABP and NDR, after adjustment for other clinical variables, such as the increase in body weight, serum albumin level, and urinary protein excretion. The data from repeated ABP measurements, before and after the achievement of remission, showed a marked decrease in the average 24-h ABP after remission. Furthermore, change in the serum sodium level was significantly correlated with the change in NDR.
  
  
  CONCLUSIONS
  These results suggest that alteration in renal handling of sodium and water, which might be reflected in serum sodium level, is involved in the abnormality of circadian blood pressure in primary NS patients.
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Kotaro
authors.initials: K
authors.lastname: Haruhara
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Nobuo
authors.initials: N
authors.lastname: Tsuboi
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Kentaro
authors.initials: K
authors.lastname: Koike
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Go
authors.initials: G
authors.lastname: Kanzaki
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okabayashi
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Takaya
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Akira
authors.initials: A
authors.lastname: Fukui
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogura
authors.affiliation: a Division of Nephrology and Hypertension, Department of Internal Medicine , The Jikei University School of Medicine , Tokyo , Japan .
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoo
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D009404:Nephrotic Syndrome / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D012964:Sodium / Q000378:metabolism
chemical_list: D012964:Sodium
keywords: Ambulatory blood pressure monitoring; nephrotic syndrome; nocturnal hypertension; non-dipper type; renal sodium handling; serum sodium