Circadian Blood Pressure Variability and Associated Factors amongst Chronic Kidney Disease Patients at Nekemte Town Public Hospitals, Western Ethiopia, 2022

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.