Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Guoxue Alley 37, Chengdu, 610041, Sichuan, China.
Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Int Urol Nephrol. 2024 Oct;56(10):3381-3388. doi: 10.1007/s11255-024-04095-5. Epub 2024 Jun 3.
We performed the study to investigate the association between heart rate (HR) non-dipping pattern and target organ damage in patients with chronic kidney disease (CKD) and hypertension.
In this cross-sectional study, 447 patients with CKD and hypertension were enrolled. 24 h ambulatory blood pressure monitoring was conducted. Linear regression and logistic regression analysis were conducted to investigate the association between HR non-dipping pattern and target organ damage, including estimated glomerular filtration rate (eGFR), left ventricular mass index (LVMI), and left ventricular hypertrophy (LVH).
Overall, 261 patients (58.4%) followed non-dipping patterns of HR. HR non-dipping pattern remained to be significantly associated with reduced eGFR (β: -0.384; 95% CI: -0.719 to -0.050; p = 0.025) and the higher prevalence of CKD stages 4-5 (OR: 2.141; 95% CI: 1.153 to 3.977; p = 0.016). Meanwhile, HR non-dipping pattern was independently associated with LVMI (β: 0.021; 95% CI: 0.000 to 0.041; p = 0.049) and LVH (OR: 1.78; 95% CI: 1.07 to 2.96; p = 0.027) after adjusting for confounding factors.
HR non-dipping pattern was independently associated with impaired renal function and cardiac damage. Non-dipping HR deserves further attention and needs to be detected and treated during the management of CKD patients.
我们进行了这项研究，以调查慢性肾脏病（CKD）和高血压患者心率（HR）非杓型模式与靶器官损害之间的关系。
在这项横断面研究中，共纳入了 447 名 CKD 合并高血压患者。进行了 24 小时动态血压监测。进行线性回归和逻辑回归分析，以调查 HR 非杓型模式与靶器官损害之间的关系，包括估算肾小球滤过率（eGFR）、左心室质量指数（LVMI）和左心室肥厚（LVH）。
总体而言，261 名患者（58.4%）的 HR 呈非杓型模式。HR 非杓型模式与 eGFR 降低（β：-0.384；95%CI：-0.719 至-0.050；p=0.025）和 CKD 4-5 期的更高患病率（OR：2.141；95%CI：1.153 至 3.977；p=0.016）仍有显著相关性。同时，在校正混杂因素后，HR 非杓型模式与 LVMI（β：0.021；95%CI：0.000 至 0.041；p=0.049）和 LVH（OR：1.78；95%CI：1.07 至 2.96；p=0.027）独立相关。
HR 非杓型模式与肾功能受损和心脏损害独立相关。非杓型 HR 值得进一步关注，在 CKD 患者的管理中需要检测和治疗。
