The Efficacy Evaluation Of Ambulatory Blood Pressure And Office Readings In Chronic Kidney Disease Patients Complicated With Hypertension

Objective:(1) To investigate the ambulatory blood pressure (ABP) characteristics of patients who have Chronic Kidney Disease (CKD) complicated with Hypertension.(2) To compare the difference of blood pressure control rate between ambulatory blood pressure and office blood pressure (OBP).Methods:We collected225CKD patients complicated with hypertension and107essential hypertensives with normal renal function in our hospital during2012.5-2013.2. The general and blood pressure information about these patients was recorded. Statistically analysing the ABP characteristics, ABP and OBP blood pressure control rate. Comparing the "White-coat" effect and Pseudo-blood pressure control rate.Results:(1) To compare with normal renal function hypertensives, The24hSBP, nocturnal BP,24hBP load, diurnal BP load,nocturnal BP load in CKD patients are significantly higher (P<0.05). The OSBP(P=0.032), anti-dipper BP rate (5.6%vs32.1%, P<0.05) and dipper BP rate (34.6%vs15.6%, P<0.05) in CKD5patients are significantly differtent. There are negative correlation between24hBP, diurnal BP, nocturnal BP, BP load, OSBP and eGFR (P<0.001).(2) The ABP blood pressure control rate is lower than OBP blood pressure control rate in CKD pstients and essential hypertensives. The ABP blood pressure control rate is higher than OBP blood pressure rate in hypertensives with CKD1-2, The ABP blood pressure control rate is lower than OBP blood pressure rate in hypertensives with CKD1-2and hypertensives with CKD5reversely. The white-coat effect rate are12%and16.8%and the masked hypertension rate are6.5%and13.8%.(3) To compare with normal renal function hypertensives, the ABP BP control rate (28.9%vs13.7%, P<0.05), nocturnal BP control rate (59.8%vs13.7%, P<0.05) and nocturnal SBP (66.8%vs15.8%, P<0.05).is lower in CKD patients.Conclusion:(1) The nocturnal blood pressure control rate, which is significantly lower in CKD patients complicated with hypertension, should be attached more attension.(2) CKD patients complicated with hypertension have a higher incidence of Pseudo-blood pressure control rate.the OBP is not a good method to judge the blood pressure control and nocturnal blood pressure control.