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Circadian changes in blood pressure and their relationships to the development of microalbuminuria in type 1 diabetic patients

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Abstract

Diabetic nephropathy in type 1 diabetic patients, as it is currently understood, progresses in a stepwise fashion from normoalbuminuria to microalbuminuria, then to overt proteinuria and progression to chronic renal failure, and ultimately to end-stage renal disease. The role of early blood pressure changes in relation to diabetic nephropathy is now better understood in light of recent data using ambulatory blood pressure monitoring as a means to monitor blood pressure changes noninvasively throughout the day. Cross-sectional studies with type 1 diabetic patients with microalbuminuria have shown that the normal nocturnal blood pressure often fails to fall normally during sleep. The question of which comes first, microalbuminuria or a rise in blood pressure in patients with type 1 diabetes, was recently addressed in a prospective study. An increase in systolic blood pressure during sleep precedes the development of microalbuminuria and may play a causative role in its development.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Feinberg School of Medicine, Northwestern University, 320 E. Superior Street, 10-475 Searle Building, 60611, Chicago, IL, USA

    Daniel Batlle MD

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  1. Donn Hogan MD
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  2. Empar Lurbe MD
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  3. M. Reza Salabat MD
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  4. Josep Redon MD
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  5. Daniel Batlle MD
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Hogan, D., Lurbe, E., Salabat, M.R. et al. Circadian changes in blood pressure and their relationships to the development of microalbuminuria in type 1 diabetic patients. Curr Diab Rep 2, 539–544 (2002). https://doi.org/10.1007/s11892-002-0125-z

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