Visit-to-visit blood pressure variability in different stages of chronic kidney disease

Abstract

Introduction: Visit-to-visit variability (VVV) of blood pressure (BP) has been associated to cardiovascular mortality, stroke, and progression of chronic kidney disease (CKD). Objective: The objective of the study was to evaluate the association between VVV of BP and changes in estimated glomerular filtration rate (eGFR) in subjects with CKD Stage 3A, 3B, and 4. Materials and methods: We analyzed the medical records of 75 CKD patients for a period of 48 months. Results: Demographic characteristics obtained revealed no differences between the three groups. The averages of the diastolic BP factor were 78.4, 74.7, and 76.5 for the CKD 3A, CKD 3B, and CKD 4, respectively. The greatest variability was observed in Stage 4 CKD with a value of 21.5%, 18.1%, and 34.80% for eGFR, systolic BP (SBP), and pulse pressure (PP), respectively. The highest coefficient of variability was 34.80% in PP in Stage 4 CKD. In CKD 3A, eGFR is significantly associated with the PP factor. In CKD 3B, eGFR is significantly associated with the SBP factor and tends to significance with the PP factor. No significant association was found between the eGFR of stage CKD 4 and the different pressure factors. Conclusion: Our results demonstrated that if VVV of BP is not observed, eGFR would not be expected to decrease.

Keywords

• Blood pressure. Chronic disease. Glomerular filtration rate.