Circadian changes in blood pressure and their relationships to the development of microalbuminuria in type 1 diabetic patients
- Cite this article as:
- Hogan, D., Lurbe, E., Salabat, M.R. et al. Curr Diab Rep (2002) 2: 539. doi:10.1007/s11892-002-0125-z
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.