J Korean Med Sci.  2011 Sep;26(9):1185-1190. 10.3346/jkms.2011.26.9.1185.

Non-Dipper Status and Left Ventricular Hypertrophy as Predictors of Incident Chronic Kidney Disease

• An HR
• Park S
• Yoo TH
• Kang SW
• Ryu JH
• Lee YK
• Yu M
• Ryu DR
• Kim SJ
• Kang DH
• Choi KB

• KMID: 1779392
• DOI: http://doi.org/10.3346/jkms.2011.26.9.1185

Abstract

We have hypothesized that non-dipper status and left ventricular hypertrophy (LVH) are associated with the development of chronic kidney disease (CKD) in non-diabetic hypertensive patients. This study included 102 patients with an estimated glomerular filtration rate (eGFR) > or = 60 mL/min/1.73 m2. Ambulatory blood pressure monitoring and echocardiography were performed at the beginning of the study, and the serum creatinine levels were followed. During the average follow-up period of 51 months, CKD developed in 11 patients. There was a significant difference in the incidence of CKD between dippers and non-dippers (5.0% vs 19.0%, P < 0.05). Compared to patients without CKD, patients with incident CKD had a higher urine albumin/creatinine ratio (52.3 +/- 58.6 mg/g vs 17.8 +/- 29.3 mg/g, P < 0.01), non-dipper status (72.7% vs 37.4%, P < 0.05), the presence of LVH (27.3% vs 5.5%, P < 0.05), and a lower serum HDL-cholesterol level (41.7 +/- 8.3 mg/dL vs 50.4 +/- 12.4 mg/dL, P < 0.05). Based on multivariate Cox regression analysis, non-dipper status and the presence of LVH were independent predictors of incident CKD. These findings suggest that non-dipper status and LVH may be the therapeutic targets for preventing the development of CKD in non-diabetic hypertensive patients.

Keyword

Blood Pressure Monitoring, Ambulatory; Hypertrophy, Left Ventricular; Renal Insufficiency, Chronic

MeSH Terms

Adult
Aged
Aged, 80 and over
Albumins/analysis
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Cholesterol, HDL/blood
Chronic Disease
Creatinine/blood/urine
Cross-Sectional Studies
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension/complications
Hypertrophy, Left Ventricular/complications/*diagnosis
Incidence
Kidney Diseases/epidemiology/*etiology/ultrasonography
Male
Middle Aged
*Predictive Value of Tests
Retrospective Studies

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