Abstract:
Background: Chronic kidney disease (CKD) is defined as the structural and functional
decline of the kidneys, marked by an estimated glomerular filtration rate of less than 60
mL/min per 1.73 m2
for at least three months. Hypertension is the second leading cause of
chronic kidney disease. In addition to high blood pressure, circadian blood pressure
variability is independently associated with CKD development and progression. Although the
link between blood pressure levels and CKD is well established, the relationship between
circadian blood pressure variability and CKD has received little attention in Africa,
particularly Ethiopia.
Objective: The aim of this study was to assess the pattern of circadian blood pressure
variability and associated factors amongst chronic kidney disease patients admitted to
Nekemte town public hospitals, western Ethiopia, 2022
Method: Comparative cross-sectional study was conducted among a total of 130 Chronic
kidney disease patients group I (hypertensive Chronic kidney disease =65) and group II
(Normotensive chronic kidney disease =65) from 01 October to 02 December, 2022. An
interviewer administered structured questionnaire was used to collect the data and physical
measurements was conducted. Data was entered into epi info version 3.1 and analyzed with
SPSS version 26. Comparison between the groups was performed by independent t-test for
continuous variables and Chi-square for categorical variables. Multivariable logistic
regression was performed to assess associated factors for non-dipping pattern in
hypertensive chronic kidney disease.
Result: The mean 24 hour SD of SBP was significantly different in hypertensive chronic
kidney disease (HCKD) and normotensive chronic kidney disease (NCKD) patients
(10.17±6.12 vs 5.4 ±2.7 mmHg, p=0.043). The prevalence of systolic blood pressure non dippers among HCKD patients was higher than NCKD patients (83% vs. 63%, p=0.010).
Current smokers and eGFR were factors independently associated with both non-dipping
systolic blood pressure and diastolic blood pressure in HCKD patients.
Conclusion: Compared to NCKD patients, HCKD patients had significantly higher circadian
blood pressure variability. Compare to dippers, non-dipper had lower mean eGFR.
