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KMID : 0191120110260091185
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Journal of Korean Medical Science
2011 Volume.26 No. 9 p.1185 ~ p.1190
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Non-Dipper Status and Left Ventricular Hypertrophy as Predictors of Incident Chronic Kidney Disease
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An Hye-Rim
Park Sung-Ha
Yoo Tae-Hyun
Kang Shin-Wook
Ryu Jung-Hwa
Lee Yong-Kyu
Yu Mi-Na
Ryu Dong-Ryeol
Kim Seung-Jung
Kang Duk-Hee
Choi Kyu-Bok
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Abstract
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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) ≥ 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.
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KEYWORD
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Blood Pressure Monitoring, Ambulatory, Hypertrophy, Left Ventricular, Renal Insufficiency, Chronic
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