Abstract:

Objective To investigate the characteristics of 24 h ambulatory blood pressure monitoring of primary and secondary glomerular disease so as to guide the individual antihypertensive treatment in clinics. Methods Sixty-four patients with primary glomerular disease were selected, more of them not undergone renal replacement treatment. Besides, 57 patients with secondary glomerular disease matched with age, gender and estimated glomerular filtration rate (eGFR) were randomly selected. Twenty-four hour ambulatory blood pressure monitoring was carried out in both groups. Results ①The 24 h mean systolic blood pressure, night mean systolic blood pressure and night systolic load in secondary glomerular disease group were significantly higher than those in primary glomerular disease group （P＜0.05）. ②There was no significant difference in blood pressure variability and morning surge between two groups （P＞0.05）. ③In primary glomerular disease group, dipper blood pressure accounted for 39.0%, non-dipper blood pressure 43.8% and anti-dipper blood pressure 17.2%. In secondary glomerular disease group, dipper blood pressure accounted for 10.5%, non-dipper blood pressure 47.4% and anti-dipper blood pressure 42.1%. There were significant differences in the percentage of abnormal blood pressure between primary glomerular disease group and secondary glomerular disease group (61.0% vs 89.5%, P＜0.05）. Conclusion The control of night systolic blood pressure in patients with secondary glomerular disease is poorer than that in patients with primary glomerular disease, and abnormal blood pressure in secondary glomerular disease is much more resistant. It is advised to individualize the antihypertensive treatment of night systolic blood pressure in patients with secondary glomerular disease.

Key words: primary chronic glomerular disease, secondary chronic glomerular disease, ambulatory blood pressure monitoring