Daily indices of central and peripheral blood pressure in patients with chronic glomerulonephritis and arterial hypertension at different stages of chronic kidney disease

Abstract


Aim. To study the daily indices of central and peripheral blood pressure in patients with chronic glomerulonephritis and arterial hypertension at different stages of chronic kidney disease.

Methods. 76 patients with chronic glomerulonephritis and arterial hypertension were examined: 13.2% with chronic kidney disease stage 1 (G1), 15.8% G2, 21.0% G3, 23.7% G4, 26.3% G5D. For the daily monitoring of central (in aorta) and peripheral blood pressure (in brachial artery), the BPLab monitor and the Vasotens-24 technology were used.

Results. In the examined patients central and peripheral systolic, diastolic, and pulse blood pressure increased with renal function decline. Thus, the daily systolic pressure increased from 112 [107; 129] mm Hg in the aorta and 127 [118; 131] mm Hg in the brachial artery in patients with G1 to 146 [137; 153] and 147 [138; 155] mm Hg with G5D; diastolic — from 76 [70; 83] and 78 [71; 85] to 96 [82; 104] and 97 [81; 107] mm Hg; pulse pressure — from 36 [33; 45] and 48 [42; 51] to 53 [45; 56] and 62 [50; 65] mm Hg (p <0.05). A statistically significant excess of peripheral values over the corresponding parameters of central blood pressure for systolic (in groups G1–2) and pulse (G1–4) pressure was detected. Thus, in patients with G2, the average daily systolic pressure was 132 [115; 136] mm Hg in brachial artery and 113 [110; 127] mm Hg in aorta, pulse pressure — 49 [41; 52] and 33 [30; 41] mm Hg (p <0.05). With further progression of renal failure, these differences were not reliably detected. Most patients had a defect of the daily aortic and brachial blood pressure rhythm but the dipper status of systolic and diastolic blood pressure was less common than brachial one (24 and 20% versus 39 and 35%, χ2=5.21 and 5.64; p <0.05).

Conclusion. The features of the peripheral and central blood pressure daily indices at different stages of chronic kidney disease in patients with chronic glomerulonephritis and arterial hypertension determine the relevance of their further study to compare the effect on cardiovascular risk and renal failure progression.


I V Polyakova

Privolzhsky Research Medical University

Author for correspondence.
Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

N Yu Borovkova

Privolzhsky Research Medical University

Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

A A Tulichev

Privolzhsky Research Medical University

Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

T I Maslova

Nizhny Novgorod Regional Clinical Hospital n.a. N.A. Semashko

Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

N Yu Linyova

Nizhny Novgorod Regional Clinical Hospital n.a. N.A. Semashko

Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

S Yu Zubova

Nizhny Novgorod Regional Clinical Hospital n.a. N.A. Semashko

Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

I Yu Maksimova

Nizhny Novgorod Regional Clinical Hospital n.a. N.A. Semashko

Email: iv-poliakova@yandex.ru
Nizhny Novgorod, Russia

  1. Svidovskaya S.V., Mikhalevskaya N.A., Galchenkova O.S., Knyazeva L.A. Proinflammatory cytokinemia and arterial stiffness in nephrogenic hypertension. Vestnik novykh meditsinskikh tekhnologiy. 2012; 19 (4): 126–127. (In Russ.)
  2. Rimoldi S.F., Scherrer U., Messerli F.H. Secondary arterial hypertension: when, who, and how to screen? Eur. Heart J. 2014; 35 (19): 1245–1254. doi: 10.1093/eurheartj/eht534.
  3. Bikbov B.T., Tomi­lina N.A. The contingent and treatment quality indicators in patients on replacement therapy of end stage renal disease in the Russian Federation in 1998–2013 years. Report of the Register of Renal Replacement Therapy of the Russian Dialysis Society. Part 2. Nefrologiya i dializ. 2016; 18 (2): 98–163. (In Russ.)
  4. Hamrahian S.M., Falkner B. Hypertension in chro­nic kidney disease. Adv. Exp. Med. Biol. 2017; 956: 307–325. doi: 10.1007/5584_2016_84.
  5. Kidney Disease: Improving Global Outcomes (­KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int. 2012; 2: 337–414. doi: 10.1038/kisup.2012.49.
  6. Kidney Disease: Improving Global Outcomes (­KDIGO) Glomerulonephritis Work Group. KDIGO clini­cal practice guideline for glomerulonephritis. Kidney Int. 2012; 2: 139–274. doi: 10.1038/kisup.2012.9.
  7. Kobalava Zh.D., Kotovskaya Yu.V., Bogomaz A.V. New methods for assessment of the cardiovascular system subclinical changes in arterial hypertension. Ratsional'naya farmakoterapiya v kardiologii. 2016; 12 (3): 317–324. (In Russ.)
  8. McEniery C.M., Cockcroft J.R., Roman M.J. et al. Central blood pressure: current evidence and clinical importance. Eur. Heart J. 2014; 35: 1719–1725. doi: 10.1093/eurheartj/eht565.
  9. Kotovskaya Yu.V., Kobalava Zh.D. Aortic pressure: modern ideas about the clinical and prognostic value of its indicators. Meditsinskiy sovet. 2013; (9): 26–34. (In Russ.)
  10. Kidney Disease: Improving Global Outcomes (­KDIGO) CKD Work Group. KDIGO 2012 Clinical practice guideline for the evaluation and management of chro­nic kidney disease. Kidney Int. 2013; 3: 1–150. doi: 10.1038/kisup.2012.77.
  11. ЕОК/ЕОАГ. Рекомендации по лечению больных с артериальной гипертензией. Рос. кардиол. ж. 2018; 23 (12): 143–228. [2018 ESC/ESH. Guidelines for the management of arterial hypertension. Rossiyskiy kar­diologicheskiy zhurnal. 2018; 23 (12): 143–228. (In Russ.)]
  12. Tomilina N.A. Khronicheskaya bolezn' pochek. Izbrannye glavy nefrologii. (Chronic kidney disease. Selected chapters of nephrology.) Moscow: GEOTAR-Media. 2017; 512 р. (In Russ.)
  13. Briet M., Boutouyrie P., Laurent S., London G.M. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int. 2012; 82: 388–400. doi: 10.1038/ki.2012.131.
  14. Zhou S., Fu J., Liu M. et al. The prevalence and risk factors of abnormal circadian blood pressure in patients with IgA nephropathy. Clin. Nephrol. 2017; 88 (12): 344–353. doi: 10.5414/CN109145.
  15. Redon J., Plancha E., Swift P.A. et al. Nocturnal blood pressure and progression to end-stage renal disease or death in nondiabetic chronic kidney disease stages 3 and 4. J. Hypertens. 2010; 28 (3): 602–607. doi: 10.1097/HJH.0b013e328333fe4d.

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© 2019 Polyakova I.V., Borovkova N.Y., Tulichev A.A., Maslova T.I., Linyova N.Y., Zubova S.Y., Maksimova I.Y.

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