The clinical value of blood pressure rhythm and plasma B-type natriuretic peptide in patients with IgA nephropathy

Objective To study the relation between circadian rhythm of blood pressure and loads of water sodium at night in patients with IgA nephropathy.Methods 103 cases of primary IgA nephropathy from February,2008 to January,2012 year registered in the hospital were included.Clinical and pathological data were collected.The changes of circadian rhythm of blood pressure and loads of water sodium at night were studied by the observation in patients with determination of ambulatory blood pressure monitoring and plasma B-type natriuretic peptide(BNP).Results The incidence of hypertension was 53.4%.The incidence of nocturnal blood pressure was 89.0% in patients with hypertension.There were 10(18.2%) cases represented anti-spoon type of blood pressure.There were 54.2% of patients with nocturnal blood pressure in normal blood pressure group.There was significant difference in the two groups(P 0.05).Plasma BNP concentrations in hypertension group were significantly higher than in normal blood pressure group(P 0.05).There were 90.9% patients with arterial intimal thickening in hypertension group.It was significantly more than normal blood pressure group(P 0.05).There was no difference in amount of urinary protein and serum creatinine(Scr),albumin(Alb),cholesterol(Chl),glomerular filtration rate(GFR),CKD stages,HASS grading,left ventricular end diastolic diameter(LVDs),end diastolic diameter(LVDd) and ejection fraction(EF)(P 0.05).Conclusion Changes in the circadian rhythm of blood pressure can occur at an earlier stage of IgA nephropathy.Plasma BNP level was closely to the changes of rhythm,and so abnormal sodium load was important factor in circadian rhythms of blood pressure changes.Limiting sodium and appropriate antihypertensive drugs may be beneficial to blood pressure control and recovery of blood pressure rhythm in IgA nephropathy.