Effects of Combined Therapy with Mycophenolate Mofetil and Glucocorticoids in IgA Nephropathy
Hong Kong Journal of Nephrology
hours, daytime and nighttime systolic and diastolic BP variations were calculated. The patients were divided into four groups based on different circadian BP rhythm: dippers, non-dippers, reversed dippers, and extreme dippers. Demographic and clinicopathologic data were collected and analyzed. Logistic regression models were used to analyze the associated factors for abnormal BP rhythms among the patients with IgAN. Results: A total of 375 IgAN patients were recruited and the mean age was (36.5
... mean age was (36.5 AE 11.7) years with 51.7% (194/375) men. The prevalence of abnormal circadian BP was high to 84% (315/375), with 82.4% in normotensive and 86.1% in hypertensive patients (P > 0.05). The non-dipper rhythm was the most common abnormal pattern (63.8%, 239/375), and then was reversed dipper (27.3%, 86/315), extreme dipper (8.9%, 28/315). Compared to the patients with normal BP rhythm, the patients with abnormal BP rhythms had higher left ventricular mass index, higher serum creatinine and uric acid but lower eGFR, higher proportion of arteriole wall thickening and small vascular hyalinosis, which was the most distinguishing in those with reversed dipper BP. Multivariate logistic regression analysis revealed that the eGFR (OR: 0.64, 95% CI: 0.45e0.93, P Z 0.037), serum uric acid (OR: 1.60, 95% CI: 1.01e2.54, P Z 0.014) and small vascular hyalinosis (OR: 2.17, 95% CI: 1.14e4.11, P Z 0.044) were independently associated with abnormal BP circadian rhythm. Conclusion: Abnormal circadian BP rhythm was common in IgAN patients independent of hypertension. The associated factors for abnormal BP rhythm among IgAN patients were the eGFR, serum uric acid, and small vascular hyalinosis. http://dx.