# Niet-dippen bij chronische nierziekte gekoppeld aan hoger sterfterisico en CV-events — meta-analyse

*geplaatst 2026-10-06 · Nierziekte · Journal of the American Heart Association · doi 10.1161/JAHA.125.048285 · https://hartvaat.nl/2026/09/29/niet-dippen-bij-chronische-nierziekte-gekoppeld-aan-hoger-sterfterisico-en-cv-ev/*

Een systematische review en meta-analyse van 63 studies (54.515 patiënten) toont aan dat niet-dippen (<10% nachtelijke bloeddrukdaling) bij chronische nierziekte (CKD) voorkomt bij 53% van de patiënten. Patiënten met CKD die wel dippen, hebben een significant lager risico op sterfte (RR 0,60), cardiovasculaire events (RR 0,63) en CKD-progressie (RR 0,64) vergeleken met niet-dippers. Deze bevindingen onderstrepen de prognostische waarde van nachtelijke bloeddrukmeting voor risicostratificatie bij nierpatiënten, hoewel de onderliggende data voornamelijk uit retrospectieve cohorts met hoge heterogeniteit bestaat.

## English: Blood Pressure Dipping Status in Chronic Kidney Disease and Association With Adverse Outcomes: A Systematic Review and Meta-Analysis.

A systematic review and meta-analysis of 63 studies (54,515 patients) found that non-dipping status (<10% nighttime blood pressure reduction) is present in 53% of patients with chronic kidney disease (CKD). Compared with non-dippers, patients who maintained a normal dipping pattern had significantly lower risks of all-cause mortality (RR 0.60), cardiovascular events (RR 0.63), and CKD progression (RR 0.64). These findings reinforce the prognostic value of ambulatory blood pressure monitoring for risk stratification in CKD, although the evidence is primarily derived from retrospective cohorts with considerable heterogeneity.

## Abstract (original, from the publication)

BACKGROUND: Nondipping, <10% nighttime blood pressure reduction, is common in chronic kidney disease (CKD). We conducted a systematic review to determine CKD nondipper prevalence, nondipper risk between patients with and without CKD and adverse events associated with nondippers in CKD. METHODS: CKD population studies undergoing an automated blood pressure monitor were searched for on MEDLINE, Embase, and CENTRAL (December 2023), included if they had nondipper information and excluded if they examined only a specific population. Random-effects analysis was conducted to determine prevalence and relative risk (RR) with 95% CI. Risk of bias was assessed with the Joanna Briggs Institute score for prevalence studies and Newcastle-Ottawa Scale for observational studies. A sensitivity analysis excluded studied with a high risk of bias. Heterogeneity was examined using I2 and SD. RESULTS: We included 63 articles with 54 515 patients; 33 825 with CKD and 20 690 without CKD. CKD nondipper prevalence was 0.53 (95% CI, 0.52-0.53, SD=13.5%). Compared with patients with CKD, those without CKD had a lower risk of nondipping status (RR, 0.69 [95% CI, 0.63-0.75], SD=14.1%, P<0.001). Similar findings were seen in the sensitivity analysis. CKD, dippers compared with nondippers, was associated with a lower mortality (RR, 0.60 [95% CI, 0.49-0.72], SD=3.2%, P<0.001), cardiovascular events (RR, 0.63 [95% CI, 0.47-0.85], SD=28.3%, P<0.001), and CKD progression (RR, 0.64 [95% CI 0.55-0.75], SD=14.1%, P<0.001). CONCLUSIONS: Nondipping is prevalent in CKD, with CKD itself a risk factor. Nondipping was associated with mortality, cardiovascular event, and CKD progression. Almost all included studies were retrospective cohorts, with a high heterogeneity found.

Auteurs: Sara Abdallah, Ghaidaa El Saddik, Sola Aoun Bahous, Hala Kilani, Siba Kallab, Hicham Cheikh Hassan

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Bron: Journal of the American Heart Association, https://doi.org/10.1161/JAHA.125.048285. Bijgewerkt 2026-09-30T01:01:30Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.