Clinical Study On The Prevalence Of Nocturnal Hypertension In Patients With Chronic Kidney Disease And Its Influencing Factors

Objective: To investigate the prevalence and influencing factors of nocturnal hypertension in patients with chronic kidney disease(CKD)and hypertension by ambulatory blood pressure monitoring(ABPM).Methods: The sample included 123 patients with CKD and hypertension,who had been hospitalized in the Department of Nephrology of Nanchong Central Hospital from January to October 2017,who used ambulatory blood pressure monitor to investigate the prevalence of nocturnal hypertension,and then divided into nocturnal hypertension group and non-nocturnal hypertension group.At the same time,the laboratory indexes were collected,including fasting blood glucose,serum albumin,serum creatinine,serum urea nitrogen,serum uric acid,blood lipid,electeolyte,C reactive protein,homocysteine,parathyroid hormone(PTH)and hemoglobin.The Colour Sonography and cervical vascular color Doppler ultrasound were used to evaluate ambulatory 24 hour blood pressure,cardiac structure and function changes and vascular plaque,respectively.The influencing factors of nocturnal hypertension were analyzed by single-factors of nocturnal hypertension were analyzed by single-factor and multiple-factor Logistic regression.Results:(1)The prevalence of nocturnal hypertension was 89.43%,and isolated nocturnal hypertension was 29.27%.The control rate of daytime hypertension vs nocturnal hypertension is 38.21% vs 10.57%.The prevalence of nocturnal hypertension increased with the decrease of glomerular filtration rate(GFR).(2)Single factor analysis showed that serum urea nitrogen,serum creatinine,serum uric acid,homocysteine,parathyroid hormone,serum potassium and serum phosphorus increased significantly,and GFR,serum albumin and hemoglobin levels were significantly lower than those without nocturnal hypertension(P<0.05).(3)Logistic regression analysis indicated that nocturnal hypertension was significantly associated with age,GFR,serum albumin,serum creatinine and homocysteine(P<0.05).Conclusion:(1)Nocturnal hypertension is prevalent in patients with CKD and hypertension,and the prevalence of isolated nocturnal hypertension is higher.(2)Age,GFR,albumin,serum creatinine and homocysteine are the influencing factors of nocturnal hypertension.(3)ABPM is an effective method for monitoring nocturnal hypertension in patients with CKD.