Chronotherapy for hypertension in patients with chronic kidney disease: a systematic review and meta-analysis in non-black patients

Wang, Caixia; Qiu, Xilian; Lv, Linsheng; Huang, Jianhua; Li, Shaomin; Lou, Tanqi; Liu, Xun

doi:10.1007/s11255-016-1437-2

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…Although the importance of chronopharmacology in the treatment of hypertension has been studied in several observational trials, only a few of these trials were randomized and controlled and most had major flaws in their design. Meta-analyses on the few existing randomized controlled trials (RCTs) confirmed that blood pressure control is improved by administering anti-hypertensive medications at bedtime in patients with hypertension and/or CKD (121)(122)(123)(124).…”

Section: Kidney Transplantationmentioning

confidence: 99%

Circadian rhythms and the kidney

2018

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Numerous physiological functions exhibit substantial circadian oscillations. In the kidneys, renal plasma flow, the glomerular filtration rate and tubular reabsorption and/or secretion processes have been shown to peak during the active phase and decline during the inactive phase. These functional rhythms are driven, at least in part, by a self-sustaining cellular mechanism termed the circadian clock. The circadian clock controls different cellular functions, including transcription, translation and protein post-translational modifications (such as phosphorylation, acetylation and ubiquitylation) and degradation. Disruption of the circadian clock in animal models results in the loss of blood pressure control and substantial changes in the circadian pattern of water and electrolyte excretion in the urine. Kidney-specific suppression of the circadian clock in animals implicates both the intrinsic renal and the extrarenal circadian clocks in these pathologies. Alterations in the circadian rhythm of renal functions are associated with the development of hypertension, chronic kidney disease, renal fibrosis and kidney stones. Furthermore, renal circadian clocks might interfere with the pharmacokinetics and/or pharmacodynamics of various drugs and are therefore an important consideration in the treatment of some renal diseases or disorders.

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Section: Kidney Transplantationmentioning

confidence: 99%

Circadian rhythms and the kidney

2018

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“…As a result, the idea of treating patients suffering from hypertension and other cardiovascular diseases with specific time-of-day dosing, otherwise known as chronotherapy, has gained considerable attention in recent years. In nondipping hypertensive patients with chronic kidney disease, bedtime dosing of antihypertensive medications may help reduce nocturnal BP and restore a rhythmic BP pattern, which also correlates with improved long-term prognosis (21,25,43). A study performed in 2,156 hypertensive subjects from a Spanish cohort showed that bedtime therapy with antihypertensive medications improved BP control and decreased the prevalence of nondipping BP (16).…”

Section: Introductionmentioning

confidence: 99%

Circadian regulation of kidney function: finding a role for Bmal1

Zhang

Pollock

2018

American Journal of Physiology-Renal Physiology

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Mounting evidence suggests that there is an internal molecular "clock" within the kidney to help maintain normal renal function. Disturbance of the kidney circadian rhythm may pose a threat to water and electrolyte homeostasis and blood pressure regulation, among many other problems. The identification of circadian genes facilitated a more comprehensive appreciation of the importance of "keeping the body on time"; however, our knowledge is very limited with regard to how circadian genes regulate kidney function. In this brief review, we summarize recent progress in circadian control of renal physiology, with a particular focus on aryl hydrocarbon receptor nuclear translocator-like protein (Arntl1; also called Bmal1).

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“…A study on 60 subjects with nonspoon-type blood pressure in CKD showed that although valsartan significantly reduced systolic and diastolic blood pressure before and after bedtime administration, it significantly improved non-spoon-type blood pressure [11]. A meta-analysis also confirmed that time therapy significantly reduced nocturnal systolic and diastolic blood pressure [12]. Nocturnal hypertension and non-spoon-type blood pressure control is improved by this treatment method.…”

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confidence: 88%

Hypertension in patients with CKD in China: clinical characteristics and management

Cai

Chen

2017

Front. Med.

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Chronic kidney disease (CKD) is a life-threatening disease that results in end-stage renal disease (ESRD) and consumes substantial health resources. In China, the prevalence of CKD in the general population is 10.8% and increases gradually with age [1]. CKD also causes hypertension. The prevalence of hypertension in the general population is 25.2% [2], and the prevalence of hypertension with CKD is much higher. From 2010 to 2011, a national epidemiological survey of CKD in hospitalized patients (PATRIOTIC study) showed that the prevalence of renal hypertension was 67.3% [3]. Another study from 2012 to 2013 indicated that the prevalence of hypertension in CKD patients was 71.2% [4], suggesting the elevating prevalence of renal hypertension.The PATRIOTIC study was a multi-center epidemiological survey, which included 61 hospitals in China. The results showed that the prevalence of renal hypertension in the elderly was 82.0%, significantly higher than that of young patients with CKD. The prevalence rates of hypertension in the elderly CKD groups aged 60-69 years, 70-79 years, and over 80 years old were 81.2%, 82.6%, and 84.5%, respectively, indicating that the older the age, the higher the prevalence rate. As eGFR falls, the prevalence rate of hypertension increases [5]. Compared with those in CKD stage 1, the prevalence rate of patients in CKD stages 3b, 4, and 5 rises significantly [6].Although the prevalence of renal hypertension remains high, awareness and treatment rate have been improved in recent years. The awareness and treatment rate of renal hypertension in the survey from 1999 to 2002 were 75.7% and 80.4% [7], respectively, which rose to 95.4% and 93.7% in the survey from 2012 to 2013 [4]. These findings suggested the dramatic improvement of the condition. Nevertheless, a survey from hospitalized patients with CKD showed that 4.6% had no knowledge of hypertension. The awareness of renal hypertension in the community was likely much lower. A telephone survey conducted in Hong Kong for the general population revealed that 43.6% of the subjects did not understand the importance of blood pressure measurement in CKD, and more than 60% were unaware that hypertension is a complication of CKD [8]. This finding indicates that efforts on the publicity, prevention, and control of hypertension in the community need to be further improved.Improving the management of hypertension plays an important role in delaying renal disease progression and complications, as well as enhances the prognosis of CKD patients. To promote hypertension management, a number of guidelines for prevention and treatment were developed, among which the Kidney Disease: Improving Global Outcomes (KDIGO) Guideline (2012) and the United States NKF KDOQI (2004) were the most influential [9,10]. The Chinese Nephrologist Association initiated and completed the Chinese Guidelines for the Management of Hypertension in CKD (2016), hoping to guide clinical practice and improve awareness, diagnosis, and treatment of hypertension in CKD in China. The KDI...

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Chronotherapy for hypertension in patients with chronic kidney disease: a systematic review and meta-analysis in non-black patients

Abstract: This meta-analysis suggests that chronotherapy could reduce nocturnal BP in hypertensive CKD patients.

Cited by 6 publications

References 25 publications

Circadian rhythms and the kidney

Circadian rhythms and the kidney

Circadian regulation of kidney function: finding a role for Bmal1

Hypertension in patients with CKD in China: clinical characteristics and management

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