The prevalence and risk factors of abnormal circadian blood pressure in patients with IgA nephropathy
The prevalence and risk factors of abnormal circadian blood pressure in patients with IgA nephropathy
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IgA肾病患者昼夜血压异常的患病率及危险因素
DOI：
10.5414/cn109145
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发表时间：
2017
影响因子：
1.1
通讯作者：
Qiongqiong Yang
中科院分区：
文献类型：
--
作者：
Shanshan Zhou;Junzhou Fu;Mingjing Liu;Shicong Yang;Qian Zhou;Xueqing Yu;Qiongqiong Yang
目的：探讨IgA肾病（IgAN）患者昼夜血压（BP）节律异常的患病率及危险因素。材料与方法：于2013年6月至2014年12月招募375例经活检证实为原发性IgAN的中国IgAN患者，根据24小时动态血压监测测量的昼夜血压节律分为四组（浅滴、非浅滴、反向浅滴和极端浅滴）。收集和分析人口统计学和临床病理资料。结果：所有受试者中昼夜血压异常的发生率为84%(315/375)，占正常患者的82.4%，占高血压患者的86.1%。随着IgAN患者估计肾小球滤过率（eGFR）的下降，患病率增加。该人群以非倾斗型最常见（63.8%,201/315），其次为反向倾斗型（27.3%,86/315），其次为极端倾斗型（8.9%,28/315）。多因素logistic回归分析显示，eGFR(优势比（OR) = 0.64, 95%可信区间（CI）： 0.45 ~ 0.93, p = 0.037）、血清尿酸（OR = 1.60, 95% CI: 1.01 ~ 2.54, p = 0.014）和小血管透明质病（OR = 2.17, 95% CI: 1.14 ~ 4.11, p = 0.044）与昼夜节律异常独立相关。结论：昼夜节律异常在IgAN患者中很常见，并发生在慢性肾病的早期阶段。低eGFR、高血清尿酸和小血管透明质病增加了IgAN患者异常血压节律的风险。
Aims: To investigate the prevalence and risk factors of abnormal circadian blood pressure (BP) rhythm among IgA nephropathy (IgAN) patients. Materials and methods: 375 Chinese IgAN patients with biopsy-proven primary IgAN were recruited from June 2013 to December 2014 and divided into four groups based on circadian BP rhythm (dippers, non-dippers, reversed dippers, and extreme dippers) measured by 24-hour ambulatory BP monitoring. Demographic and clinicopathologic data were collected and analyzed. Results: The prevalence of abnormal circadian BP was 84% (315/375) in all the participants, accounting for 82.4% of the normotensive patients and 86.1% of the hypertensive patients. The prevalence increased with the decline of estimated glomerular filtration rate (eGFR) in IgAN patients. The non-dipper pattern was most frequent (63.8%, 201/315) in this population, followed by the reversed-dipper (27.3%,86/315), and then the extreme-dipper pattern(8.9%, 28/315). Multivariate logistic regression analysis revealed that the eGFR (odds ratio (OR) = 0.64, 95% conficence interval (CI): 0.45 – 0.93, p = 0.037), serum uric acid (OR = 1.60, 95% CI: 1.01 – 2.54, p = 0.014), and small vessel hyalinosis (OR = 2.17, 95% CI: 1.14 – 4.11, p = 0.044) were independently associated with abnormal circadian BP rhythm. Conclusion: Abnormal circadian BP rhythm was common in IgAN patients and occurred in the early stages of chronic kidney disease. Low eGFR, high serum uric acid, and small vessel hyalinosis increased risk of abnormal BP rhythm in IgAN patients.