Nocturnal Dipping and Kidney Function Decline: Findings From the CKD in Children Study

Bakhoum, Christine Y; Phadke, Manali S.; Deng, Yong; Samuels, Joshua; Garimella, Pranav S.; Furth, Susan L.; Wilson, F. Perry; Ix, Joachim H.

doi:10.1016/j.ekir.2022.08.002

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Decreased HR contributes to lower cardiac output at night, whereas stroke volume is unaffected [ 49 ]. Differences in cardiac output and systemic vascular resistance between day and night have been examined in several studies [ 49 , 76 , 90 ]. There seems to be a lack of consistency in research results.…”

Section: Reviewmentioning

confidence: 99%

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Effects of Nondipping Blood Pressure Changes: A Nephrologist Prospect

Habas,

Akbar,

Alfitori

et al. 2023

Cureus

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Blood pressure (BP) variations depend on various internal, environmental, and behavioral factors. BP fluctuations occur both in normotensive and hypertensive people. Although it fluctuates over the 24-hr day and night, the morning BP increases after waking up and declines throughout sleep. It is typical for BP to decrease by 10% to 20%, while sleeping, known as dipping BP. However, if there is no decrease in nighttime mean systolic BP or a drop of less than 10 mmHg, it is called nondipping BP. Conversely, reverse dipping BP means an increase in mean systolic BP instead of a drop during the night. Reverse dipping is observed in hypertension (HTN), diabetes mellitus (DM), chronic kidney disease (CKD), and obstructive sleep apnea (OSA) syndrome. The introduction of ambulatory BP monitoring (ABPM) led to the emergence of identifying normal and elevated BP patterns. Non-dipping BP increases the risk of cardiovascular system (CVS) complications such as left ventricular hypertrophy, proteinuria, glomerular filtration rate (GFR) reduction, and CKD progression. A loss or blunting of the normal BP profile is recognized as a deleterious variant, and restoring abnormal BP patterns has been reported to significantly impact end-organ damage, morbidity, and mortality. In this non-systematic clinically-oriented, comprehensive review, we aim to update the BP variables and the pathophysiology of nondipping BP and point out the areas which need more investigation from a nephrology perspective because the nondipping BP increases the risk of proteinuria, GFR reduction, and CKD progression. A literature search of PubMed, Google, EMBASE, and Google Scholar was conducted. Checks of selected papers and relevant reviews complemented the electronic search. With improved BP measurement methods, the physiology of BP profile variations is readily detectable during the day and night. A nondipping BP profile is a distinct BP pattern that may have significant end-organ damage effects and therapeutic importance for nephrologists. The pathophysiology of the nondipping BP variant must be clarified to prevent complications, and further investigations are required. Furthermore, there is debate about the best BP index to utilize: systolic BP, diastolic BP, mean arterial pressure, or a mixture of all. All these areas are important and need new research projects.

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Section: Reviewmentioning

confidence: 99%

“…The nondipping BP pattern is common in children. However, in a cohort study of children with CKD, Bakhoum et al observed that nondipping is not linked to ESRD, a drop in eGFR, or a change in proteinuria level [ 90 ].…”

Section: Reviewmentioning

confidence: 99%

Effects of Nondipping Blood Pressure Changes: A Nephrologist Prospect

Habas,

Akbar,

Alfitori

et al. 2023

Cureus

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“…Furthermore, in all these patients, blood hypertension is an independent risk factor for renal and cardiovascular diseases [3]. However, whether blood pressure monitoring represents a reliable tool is debated, highlighting that recent research has not identified a correlation between nocturnal blood pressure dipping and CKD progression in mild-to-moderate CKD pediatric patients [4].…”

mentioning

confidence: 99%

Renal Biomarkers and Novel Therapies in Pediatric Nephrology: From Chronic Kidney Disease to Renal Transplantation

Chirico¹,

Mancuso²

2023

JCM

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“…The study by Bakhoum et al. , 7 published in this issue of Kidney International Reports , expands our understanding of nocturnal dipping, focusing on children with kidney disease who are participating in the Chronic Kidney Disease in Children study. Chronic Kidney Disease in Children is a longstanding, well conducted prospective cohort study capturing the trajectory of children with chronic kidney disease, where data are relatively scarce compared to children with kidney failure.…”

mentioning

confidence: 99%

“… 9 Therefore, though the findings of Bakhoum et al. 7 add to the body of evidence against incorporating dipping status into routine follow-up and more specifically for children with kidney disease, we should avoid abandoning the measure altogether. As ambulatory BP monitoring becomes more accessible, we look forward to seeing more studies examining the importance of nocturnal dipping that should further define its role in clinical care.…”

mentioning

confidence: 99%

Expanding Insights Into the Role of Nocturnal Blood Pressure Variation in Children

Larkins

2022

Kidney International Reports

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Nocturnal Dipping and Kidney Function Decline: Findings From the CKD in Children Study

Cited by 7 publications

References 30 publications

Effects of Nondipping Blood Pressure Changes: A Nephrologist Prospect

Effects of Nondipping Blood Pressure Changes: A Nephrologist Prospect

Renal Biomarkers and Novel Therapies in Pediatric Nephrology: From Chronic Kidney Disease to Renal Transplantation

Expanding Insights Into the Role of Nocturnal Blood Pressure Variation in Children

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