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

• Published in: BMJ open 2024-08, Vol.14 (8), p.e083014
• Main Authors: Itana, Teferi Babu, Tadelle, Amanuel, Legesse, Bruck Tesfaye, Hailu, Alemu Merga, Abebe, Samuel Taddese
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood pressure; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; chronic disease; Circadian rhythm; Circadian Rhythm - physiology; clinical physiology; Creatinine; Cross-Sectional Studies; Data collection; Ethiopia - epidemiology; Female; Glomerular Filtration Rate; Hospitals; Hospitals, Public; Humans; Hypertension; Hypertension - epidemiology; Hypertension - physiopathology; Kidney diseases; Logistic Models; Male; Middle Aged; nephrology; Original Research; Pathology; Patients; Questionnaires; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - physiopathology; Sample size
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-083014

ObjectiveThis 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.DesignA 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).SettingTwo public hospitals in the Nekemte town, Western Ethiopia.ParticipantsThe participants were two independent groups. Group I (HCKD=65) and group II (normotensive CKD (NCKD)=65).ResultsThe 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.ConclusionCompared with NCKD patients, HCKD patients had significantly greater CBPV. Compared with dippers, non-dippers had a lower mean eGFR.