Association of home blood pressure variability with progression of chronic kidney disease

Objective Home blood pressure (HBP) has been found to be a predictor of the progression of chronic kidney disease (CKD). The objective of this study is to clarify the clinical significance of day-by-day HBP variability on the progression of CKD. Methods We recruited 135 patients with stage 3-5 CKD, who performed daily HBP measurements, every morning and evening over 7 consecutive days and recorded every 6 months, with a follow-up of 36 months. We examined the associations between the variables of blood pressure (BP) variability [SD, coefficient of variation (CV), average real variability (ARV)], and renal outcomes. Results No significant correlations were found between the SD values, the CV values, the ARV values of each BP measurement, and the change in estimated glomerular filtration rate on multivariate regression analysis (beta of SD, CV, and ARV of morning systolic BP: 0.04, 0.04, and 0.02; P = 0.69, 0.63, and 0.20, respectively). None of these variables of each BP measurement showed a significant risk of renal events on multivariate Cox proportional hazards analysis (hazard ratios of SD, CV, and ARV of morning systolic BP: 0.99 (95% confidence intervals: 0.80-1.23), 0.97 (0.72-1.31), and 1.01 (0.83-1.24); P = 0.94, 0.86, and 0.92, respectively). Conclusion Day-by-day BP variability as assessed by HBP measurements had no significant association with the progression of CKD. Blood Press Monit 17:1-7 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.