This study examined the daily blood pressure profile of patients with renal insufficiency to clarify whether daily blood pressure patterns influence the prognosis of their renal functions. The 24hour blood pressure profiles of 630 patients with renal impairment were measured and the serum creatinine (S-Cr) levels of the patients were determined. S-Cr levels were then checked one year later to evaluate the changes in renal function in 178 cases. Although only 5% of the patients with an S-Cr level of under 1.4 mg/dl exhibited a sustained morning rise, 32% of patients with an S-Cr level of over 5.0 mg/dl exhibited a sustained morning rise. Non-dipper type hypertension were in 29% of patients with an S-Cr level of under 1.4 mg/dl and in 46% of patients with an S-Cr level of over 5.0 mg/dl. The renal function of patients with a sustained morning rise deteriorated more quickly than that of patients with a non-sustained morning rise, independent of their mean blood pressure (p=0.029). These data indicated that a sustained morning rise in blood pressure was more often seen in cases of severe renal impairment and should be controlled to suppress renal deterioration in patients with renal insufficiency
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