Differences in estimated glomerular filtration rate are associated with different patterns of 24-h ambulatory blood pressure in the general population

초록

Background: Alterations of the circadian blood pressure rhythm are associated with cardiovascular and chronic kidney diseases. We investigated the relationship between 24-h ambulatory blood pressure monitoring (ABPM) patterns and eGFR differences in participants without chronic kidney disease. Method: This cross-sectional study was conducted using data from the ongoing Korean Genome and Epidemiology Study, which involves 1733 participants (age, 60 ± 7 years; 938 women) with an eGFR >60 ml/min per 1.73 m2. The blood pressure dipping status was stratified as reverse-dipper (<0%), nondipper (0 to <10%), and dipper (≥10%). They were also categorized into eGFR quartiles (Q4, 128.6–101.6; Q3, 101.5–95.7; Q2, 95.6–87.4; and Q1, 87.3–60.5), and Q4 was fixed as the reference. Results: The proportion of dippers progressively decreased and the proportions of reverse and nondippers significantly increased from the highest to the lowest eGFR quartile (P < 0.001). In the univariate analyses, the Q1 and Q2 groups were significantly associated with increasing odds ratios (ORs) for the nondipper, reverse-dipper, and nondipper plus reverse-dipper groups. After adjustment, the lowest eGFR group was significantly associated with the reverse-dipper and nondipper plus reverse-dipper patterns in comparison with the highest eGFR group [OR = 1.685, 95% confidence interval (CI), 1.002–2.834; OR = 1.422, 95% CI, 1.023–1.978, respectively). The significant linear trend for an association of the nondipper plus reverse-dipper pattern with a decrease in eGFR was confirmed with the test for trend (P = 0.023). Conclusion: Differences in eGFR are associated with different 24-h ABPM patterns in non-CKD individuals. ABPM can identify individuals with a nondipper status in this population.

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