V.В. Bezrodny Relationship between renal function and circadian rhythm of blood pressure, carbohydrate and lipid metabolism in hypertensive patients

The study objective was to investigate relationship between renal function and circadian rhythm, carbohydrate and lipid metabolism in arterial hypertensive patients. We examined 98 untreated non-diabetics essential
hypertensive patients with hypertensive nephropathy. Inflammatory marker C-reactive protein was evaluated by immunoassay, uric acid serum concentration was determined by fermentative method. 24-h urinary collection
was used for estimation of glomerular filtration rate (GFR). Microalbuminuria (MA) was detected in 24-h urinary samples. Baseline lipid parameters were evaluated. The patients with hypertensive nephropathy had disturbances of circadian rhythm associated with non-dipper status and increased systolic blood pressure (BP) variability. In hypertensive nephropathy patients significant reverse correlation was found between GFR and
mean systolic BP during 24 hours, day-time and night-time (r=-0.296, Р<0.001; r=-0.291, Р<0.01 and r=-0.358, Р<0.001 respectively), as well as mean night-time diastolic BP (r=-0.384, Р<0.001). Significant, reverse correlation was also found between GFR and НОМА (r=-0.417, Р<0.001), fasting insulin and glucose (r=-0.248, Р<0.05; r=-0.397, Р<0.001 respectively) and insulin at 60 minutes of oral glucose-tolerance test (r=-0.308, Р<0.001). Increased levels of uric acid and CRP in hypertensive patients were associated with hypertensive renal impairment (GFR decline and increased level of MA). Hypertensive kidney damage was associated with lipid metabolism disorders – increased levels of total cholesterol, low-density lipoproteins and triglycerides.

Full article