Change in GFR in relation to pulse rate, dipping blood pressure, anti-hypertensives, NLR and PLR in patients with chronic kidney disease

Abstract

This study aimed to evaluate the change in glomerular filtration rate (GFR) in chronic kidney disease (CKD) patients in relation to certain 24-h ambulatory blood pressure monitoring (ABPM) parameters and anti-hypertensives and inflammatory markers. This retrospective study included 206 adult CKD patients (mean±SD age: 51.3±17.1 years, 54.9% females). We recorded the data on patient demographics, comorbidity and medications, 24-h ABPM parameters (pulse rate and dipping systolic and diastolic BP), neutrophil-to-lymphocyte ratio (NLR), platelet-tolymphocyte ratio (PLR) and GFR. We evaluated the change in e-GFR values from baseline concerning study variables. There was a mean -1.5mL/min/1.73m 2 (range -80.2 to 18.1) decline from baseline GFR during the study period. The decrease in GFR from baseline was significantly lower in patients with vs without diuretic therapy (median 1.2 vs 0 mL/min/1.73m 2 , p=0.017). The GFR change from baseline was positively correlated with the patient age (r=0.145, p=0.040) as well as with the total (r=0.198, p=0.005), day-time (r=0.184, p=0.009) and night-time (r=0.219, p=0.003) pulse rate. We noted no significant difference in the GFR change from baseline concerning gender, anti-hypertensive medications other than diuretics, dipping systolic or diastolic BP values or inflammatory markers. Our findings revealed a significant correlation between age, pulse rate and diuretic usage but not dipping systolic or diastolic BP or inflammatory markers with the GFR change from baseline.