Diurnal blood pressure variations in incipient and end stage diabetic renal disease

Diabetes Res Clin Pract. 2000 Jul;49(1):1-6. doi: 10.1016/s0168-8227(00)00136-4.

Abstract

Our aim was to compare the diurnal blood pressure patterns of people with Type 1 diabetes on continuous ambulatory peritoneal dialysis (CAPD, n=9) or haemodialysis (n=10) to diabetic patients with normo-albuminuria (n=12) or micro-albuminuria (n=15). Blood pressure was measured with an ABPM02 Meditech oscillometric blood pressure monitor. The micro-albuminuric group had significantly higher nocturnal diastolic and mean arterial pressures than the normo-albuminuric group. CAPD and haemodialysis patients had significantly higher day time, nocturnal mean systolic, diastolic and mean arterial blood pressures. Micro-albuminuric and end-stage renal failure patients displayed a loss of the physiological drop of systolic blood pressure, which was only significant in the normo-albuminuric group. Nocturnal drop of blood pressure characterised by diurnal indices were 7.4% in the CAPD, 8.8% in the haemodialysis, 10.0% in the micro-albuminuric and 16.5% in the normo-albuminuric group. These results suggest, that pathological circadian blood pressure variation is common in diabetic patients on dialysis, and ambulatory blood pressure monitoring can be a useful tool both in its the detection and its adequate treatment.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / blood
  • Albuminuria / urine
  • Blood Glucose / analysis
  • Blood Pressure Monitoring, Ambulatory
  • Blood Pressure*
  • Blood Urea Nitrogen
  • C-Peptide / blood
  • Cholesterol / blood
  • Circadian Rhythm
  • Creatinine / blood
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / complications*
  • Diabetic Nephropathies / physiopathology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypertension / complications*
  • Hypertension / physiopathology
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory
  • Renal Dialysis
  • Triglycerides / blood
  • beta 2-Microglobulin / blood
  • beta 2-Microglobulin / urine

Substances

  • Blood Glucose
  • C-Peptide
  • Glycated Hemoglobin A
  • Triglycerides
  • beta 2-Microglobulin
  • Cholesterol
  • Creatinine