Bi S-H, Cheng L-T, Zheng D-X, Wang T
Division of Nephrology, Peking University Third Hospital, Beijing, China.
Clin Nephrol. 2010 Mar;73(3):216-20. doi: 10.5414/cnp73216.
Seasonal variation in blood pressure (BP) in different populations has been described. However, no study has concentrated on the change of blood pressure in chronic kidney disease (CKD) patients, a large and growing population worldwide. Furthermore, the role of volume status in seasonal blood pressure variations remains controversial.
109 CKD patients in a single center were followed between January 1, 2007 and December 31, 2007. Systolic and diastolic blood pressure, level of serum creatinine and body weight were measured in these patients and studied along with climatology data obtained from Beijing Weather Bureau.
Blood pressure varied throughout the year, following a cyclic pattern. It increased from the autumn months toward winter, and decreased toward the spring and warmer months. The seasonal variation of blood pressure in CKD patients appeared not to correlate with CKD stage and similar seasonal variations were observed. Blood pressure values in the cohort of CKD patients were inversely correlated with outdoor temperatures (SBP: r = -0.882, p < 0.001; DBP: r = -0.860, p < 0.001). Furthermore, there was no significant difference in body weight between summer and winter (p > 0.05) in this group of CKD patients.
Our results suggest that the blood pressure of CKD patients varied with the seasonal variation. The seasonal variation of blood pressure in CKD patients seemed to have no correlation with stage of CKD or change of body weight but was inversely associated with outdoor temperatures. These results suggested that volume status might not be a key mechanism causing seasonal variation in blood pressure.
不同人群的血压(BP)存在季节性变化已被描述。然而,尚无研究聚焦于慢性肾脏病(CKD)患者的血压变化,而这一群体在全球范围内数量庞大且不断增加。此外,容量状态在季节性血压变化中的作用仍存在争议。
2007年1月1日至2007年12月31日期间,对单中心的109例CKD患者进行随访。测量这些患者的收缩压和舒张压、血清肌酐水平及体重,并结合从北京市气象局获取的气象数据进行研究。
血压全年呈周期性变化。从秋季到冬季升高,而到春季及较温暖月份降低。CKD患者的血压季节性变化似乎与CKD分期无关,且观察到类似的季节性变化。CKD患者队列中的血压值与室外温度呈负相关(收缩压:r = -0.882,p < 0.001;舒张压:r = -0.860,p < 0.001)。此外,该组CKD患者夏季和冬季的体重无显著差异(p > 0.05)。
我们的结果表明,CKD患者的血压随季节变化而变化。CKD患者血压的季节性变化似乎与CKD分期或体重变化无关,而是与室外温度呈负相关。这些结果提示,容量状态可能不是导致血压季节性变化的关键机制。