The relationship between the ambulatory pulse pressure and impaired nocturnal blood pressure decline in progression of nephropathy in type 2 diabetic patients

Objective To evaluate the predictive value of ambulatory pulse pressure (PP) and decreased nocturnal BP reduction for Type 2 diabetic nephropathy progression.Methods A retrospective analysis of clinical feamres of diabetic nephropathy was conducted based on 154 cases in our department during the time from 2004 to 2008.There were 37 diabetea mellitus without nephropathy,117 diabetic nephmpathy which included 65 early diabetic nephmpathy and 52 diabetic nephmpathy with overt proteinuria.Serum levels of ereadnine and blood pressure,albuminuria,HbA1c were monitored in the two groups,and their levels were compared.Results Age,sex,course of disease,BMI,HbA1c were not significantly different among the B groups.Pulse pressure and impaired nocturnal BP decline had significant positive effect OR the progression of diabetic nephmpathy (95% CI:1.248-3.262 and 1.468-3.682).Conclusions Ambulatory PP and iropaired nocturnal BP decline are strong.independent predictors of nephropathy progression in type 2 diabetic patients. Key words: Diabetic nephropathy;  Pulse pressure;  Impaired nocturnal BP decline;  Urinary ulbumin/creatinilie ratios