Circadian blood pressure variability and associated factors among chronic kidney disease patients at Nekemte Town public Hospitals, West Oromia, Ethiopia: a comparative cross-sectional study

BMJ Open. 2024 Aug 28;14(8):e083014. doi: 10.1136/bmjopen-2023-083014.

Abstract

Objective: This study aimed to assess the pattern of circadian blood pressure variability (CBPV) and associated factors among chronic kidney disease (CKD) patients admitted to Nekemte Town public Hospitals.

Design: A hospital-based comparative cross-sectional study was conducted among 130 CKD patients from 01 October to 02 December 2022. Comparisons were performed between the groups using an independent t-test for CBPV (24-hour blood pressure (BP), daytime BP and night-time BP). The dipping pattern was compared by the χ2 test. Multiple logistic regression was used to determine the factors associated with non-dipping patterns in patients with hypertensive CKD (HCKD).

Setting: Two public hospitals in the Nekemte town, Western Ethiopia.

Participants: The participants were two independent groups. Group I (HCKD=65) and group II (normotensive CKD (NCKD)=65).

Results: The mean 24-hour SD of systolic blood pressure (SBP) was significantly different between HCKD and NCKD patients, 10.17±6.12 mm Hg versus 0.5.4±2.7 mm Hg, respectively (95% CI 0.02 to 1.77, p=0.043). The prevalence of SBP non-dippers was greater among HCKD than NCKD patients (83% vs 63%). Mean 24-hour SBP (95% CI 1.50 (1.15 to 1.96), p=0.003) and estimated glomerular filtration rate (eGFR) (95% CI 2.92 (1.21 to 47.06), p=0.038) were independently associated with non-dipping SBP in HCKD patients.

Conclusion: Compared with NCKD patients, HCKD patients had significantly greater CBPV. Compared with dippers, non-dippers had a lower mean eGFR.

Keywords: blood pressure; chronic disease; clinical physiology; nephrology.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Blood Pressure Monitoring, Ambulatory
  • Blood Pressure* / physiology
  • Circadian Rhythm* / physiology
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Glomerular Filtration Rate
  • Hospitals, Public*
  • Humans
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Logistic Models
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / physiopathology