Ambulatory blood pressure monitoring in patients with diabetic nephropathy

Title : Ambulatory blood pressure monitoring in patients with diabetic nephropathy

Abstract:

Diabetic nephropathy (DN) is the main cause of renal failure worldwide. DN is often associated with high blood pressure (BP), and these two pathologies seem to maintain each other. However, the impact of this nephropathy on the fluctuations of blood pressure is not well established. We conducted a case-control study over one year, considering patients who had a valid ambulatory blood pressure measurement (ABPM) in our department. Patients with end-stage renal disease were excluded. Twenty-five patients with DN were compared with control groups. A first group of 25 diabetic patients with no kidney disease, and a second group of 50 patients with chronic kidney disease (CKD) and no diabetes.

Among diabetic patients, DN was associated with higher systolic BP (151 ± 16 mmHg versus 127 ± 10 mmHg; p < 0.001), but there was no difference in the diastolic BP (78 ± 12 mmHg versus 73 ± 9 mmHg; p = 0.43). The prevalence of systolic and/or diastolic hypertension was higher in cases of DN (p=0.013). In addition, a reverse dipper pattern, was frequently observed in cases of DN (32% versus 2%, p= 0.002). Among CKD patients, DN was associated with higher systolic BP (151 ± 16 mmHg versus 135 ± 17 mmHg; p = 0.001) and similar diastolic BP (78 ± 12 mmHg versus 82 ± 8 mmHg p = 0.25). The prevalence of hypertension was comparable. However, patients with ND had more abnormal BP rhythm which is reverse dipper (32% versus 8%, p value = 0.004). Diabetic nephropathy impacts more the systolic value of blood pressure than the diastolic value. It is also correlated with reverse dipper patterns present in third of patients.

Audience Take Away:

• This presentation helps with the understanding and management of hypertension in cases of diabetic nephropathy
• Understanding the relationship between high blood pressure and diabetic nephropathy is vital for healthcare providers to develop comprehensive treatment plans that effectively manage both conditions
• Then risks of developing complications associated with diabetic nephropathy can be minimized

Biography:

Dr. Barbouch was graduated from The Faculty of Medicine of Tunis, Tunisia. Then she worked in the Faculty of Medicine of Tunis and in the department of medicine A in Charles Nicolle Hospital in Tunis, as an assistant physician, then as an associate professor and since 2020 as a professor in nephrology. She also participated in working group of the national society of nephrology, dialysis, and renal transplantation (STNDT). Since 2021, she became the president of the national college of nephrology in Tunisia. She has more than 290 publications about hypertension, interstitial nephritis, secondary peritonitis, kidney transplant, and parathyroidectomy.