Non-dipping circadian pattern as a predictor of incipient nephropathy in normotensive normoalbuminuric type 1 diabetics

The objective of this study was to assess the value of the abnormal circadian blood pressure pattern by ambulatory blood pressure monitoring (ABPM) to predict the onset of abnormal albuminuria in normotensive and normoalbuminuric DM patients. The participators were submitted to ABPM and followed pro...

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Bibliographic Details
Published in:	Chronobiology international Vol. 40; no. 12; p. 1523
Main Authors:	Jorge da Silva Franco, Roberto, Antonio Vieira Filho, José, Inomata Cardoso da Silva, Douglas, Cuadrado Martin, Luis, Alves Silva, Bruno, Garcia Zanati Bazan, Silméia, Barretti, Pasqual, Regina Nogueira, Célia
Format:	Journal Article
Language:	English
Published:	England 02-12-2023
Subjects:	Albuminuria Blood Pressure - physiology Blood Pressure Monitoring, Ambulatory Circadian Rhythm - physiology Diabetes Mellitus, Type 1 Humans Hypertension Kidney Diseases Male ambulatory blood pressure monitoring diabetes mellitus Albuminuria blood pressure circadian rhythm diabetic nephropathy
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Summary:	The objective of this study was to assess the value of the abnormal circadian blood pressure pattern by ambulatory blood pressure monitoring (ABPM) to predict the onset of abnormal albuminuria in normotensive and normoalbuminuric DM patients. The participators were submitted to ABPM and followed prospectively until the onset of albuminuria or the end of follow-up. The patients with normal circadian blood pressure pattern were compared with the non-dippers in regard of the time interval free of albuminuria. The survival curves were evaluated by the Kaplan-Meier method. Of 34 patients screened, 10 patients matched the exclusion criteria. Therefore, 24 patients were submitted to ABPM, aged 24 ± 8.3 y, 18 men, and all Caucasian. Elevated levels of albuminuria did not occurin any individual with normal systolic blood pressure dip (>10%) at 54 months of follow-up. Only 22% of patients among non-dippers were free of albuminuria (<30 mg/g maintained for 3 months) at the same time ( = 0.049). Patients that reached the outcome were homogeneous in regard to other clinical and ABPM data evaluated. Abnormal systolic blood pressure circadian pattern predicts the evolution to incipient nephropathy in normotensive normoalbuminuric DM patients.
ISSN:	1525-6073
DOI:	10.1080/07420528.2023.2282471