IMPORTANCE OF 24-HR AMBULATORY BLOOD PRESSURE MONITORING IN CHRONIC KIDNEY DISEASE PROGRESSION

Background- Hypertension is one of the leading risk factor for Chronic Kidney Disease and non-dipper pattern of blood pressure is very common in chronic kidney disease patients and affects the renal outcome in these patients.Ambulatory blood pressure monitoring assists in targeting this population. Methods- Total 160 non diabetic hypertensive patients were enrolled between 10/04/14 to 15/05/15 at M.L.N. Medical College and SRN Hospital, Allahabad. Out of them 80 were CKD patients who were taken as cases and remaining 80 patients were non CKD and taken as controls. Ambulatory blood pressure monitoring, clinic BP, eGFR, and other clinical data were collected for 1 year duration. Statistical analysis was done by using unpaired t-test for independent variables. Results- out of 160 non diabetic hypertensive patients, 48(60%) cases and 28(35%) controls were found non-dippers, while remaining 32(40%) cases and 52(65%) controls were have dipper BP pattern. Patients with non-dipping BP pattern had the worst renal function (P <0.05). The eGFR shown significant relationship with the nocturnal BP. Conclusion- Ambulatory blood pressure measurement allows a better risk stratification compared to clinic blood pressure measurement. Non-dipping status is closely related to severe renal damage in CKD patients. Hence 24-hr ABPM can be used as prognostic markers in non diabetic CKD patients, and Lowering of nocturnal BP will reduce the risk of renal damge in these patients.