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Chronotherapy for hypertension in patients with chronic kidney disease: a systematic review and meta-analysis in non-black patients

  • Nephrology – Review
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Abstract

Purpose

To investigate the effects of chronotherapy on blood pressure in patients with chronic kidney disease (CKD).

Methods

We searched PUBMED, EMBASE, ASN-ONLINE, the Cochrane Library and the reference articles of published papers without language restriction, for randomized and non-randomized trials that assessed the effect of chronotherapy versus morning dosing regimen drug therapy for CKD patients with hypertension. Meta-analysis was done with random-effect models.

Results

After application of inclusion/exclusion criteria, three randomized controlled trials including 3380 patients were analyzed. Compared with morning dosing regimen drug therapy, chronotherapy was associated with a significant decrease of 3.55% in sleep-time relative decline of systolic blood pressure (SBP) (mean difference [MD], 95% CI, [0.22, 6.88]). In the chronotherapy group, we noted a significant decrease in nocturnal SBP (MD −3.79 mmHg, 95% CI, [−7.18, −0.41]) and nocturnal diastolic blood pressure (MD −1.55 mmHg, 95% CI. [− 2.28, −0.82]), but there was a small increase in awake SBP by 1.19 mmHg (MD, 95% CI, [0.06, 2.31]). No significant difference was noted in all-cause mortality and cardiovascular mortality.

Conclusion

This meta-analysis suggests that chronotherapy could reduce nocturnal BP in hypertensive CKD patients.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (Grant Nos. 81370866 and 81070612), the China Postdoctoral Science Foundation (Grant No. 201104335), Guangdong Science and Technology Plan (Grant Nos. 2011B031800084 and 2013B021800190), the Fundamental Research Funds for the Central Universities (Grant No. 11ykpy38) and the National Project of Scientific and Technical Supporting Programs funded by Ministry of Science and Technology of China (Grant No. 2011BAI10B00).

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Correspondence to Tanqi Lou or Xun Liu.

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The authors declare that they have no conflict of interest.

Additional information

Caixia Wang, Xilian Qiu and Linsheng Lv have contributed equally to the paper.

Xun Liu and Tanqi Lou have contributed equally to the paper.

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Wang, C., Qiu, X., Lv, L. et al. Chronotherapy for hypertension in patients with chronic kidney disease: a systematic review and meta-analysis in non-black patients. Int Urol Nephrol 49, 651–659 (2017). https://doi.org/10.1007/s11255-016-1437-2

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  • DOI: https://doi.org/10.1007/s11255-016-1437-2

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