Document Detail

Nocturia, nocturnal activity, and nondipping.
MedLine Citation:
PMID:  19581500     Owner:  NLM     Status:  MEDLINE    
Patients with chronic kidney disease have less than expected decline in blood pressure during sleep (nondipping) and commonly experience the vexing symptom of nocturia. To better understand the relationship among nocturia, nighttime physical activity, and nondipping, we studied 98 patients with chronic kidney disease on 2 occasions, 1 month apart, with 24-hour ambulatory blood pressure monitoring and simultaneous activity monitoring with wrist actigraphy. Patients with nocturia had greater actigraphically recorded nighttime physical activity compared to those with no nocturia. The drop in activity from wake to sleep was reduced to a similar extent whether the patients had nocturia once or twice, but patients who had nocturia >/=3 times had the least reduction from wake to sleep activity (P<0.001 versus those with less degrees of nocturia). Those with nocturia had a lesser drop in systolic ambulatory blood pressure during sleep compared with those without nocturia. The average fall in sleep systolic blood pressure was 9.8 mm Hg (95% CI: 8.0 to 11.6 mm Hg) in those without nocturia compared with 3.4 mm Hg (95% CI: 2.7 to 4.1 mm Hg) in those with any severity of nocturia (P<0.001 for difference). Nondipping in patients with nocturia was mediated by nighttime physical activity. These differences were independent of estimated glomerular filtration rate, albuminuria, or use of diuretics. Thus, nocturia, which may reflect impaired renal tubular function, is associated with nondipping in patients with chronic kidney disease and appears to be mediated by increased nocturnal activity. Whether nocturia itself or the resulting nondipping associated with nocturia is of prognostic importance for cardiorenal events in patients with chronic kidney disease should be tested in future studies.
Rajiv Agarwal; Robert P Light; Jennifer E Bills; Lindsey A Hummel
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2009-07-06
Journal Detail:
Title:  Hypertension     Volume:  54     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-20     Completed Date:  2009-09-18     Revised Date:  2009-11-23    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  646-51     Citation Subset:  IM    
Indiana University and Veterans' Administration Medical Center, 1481 West 10th Street, Indianapolis, IN 46202, USA.
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MeSH Terms
Aged, 80 and over
Albuminuria / physiopathology
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory / methods
Glomerular Filtration Rate
Kidney Failure, Chronic / physiopathology*
Middle Aged
Nocturia / physiopathology*
Polysomnography / methods
Comment In:
Hypertension. 2009 Dec;54(6):e139; author reply e140   [PMID:  19841282 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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