ORIGINAL ARTICLE Urinary albumin, protein excretion and circadian blood pressure in patients with fibromyalgia Baris Afsar • Rukuye Burucu Received: 26 November 2012 / Accepted: 3 April 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract Recent evidence suggests that patients with fibromyalgia (FM) have increased oxidative stress, inflammation, endothelial dysfunction and autonomic dysfunction. These factors are also shown to be responsible for increased urinary albumin and protein excretion and deranged circadian blood pressure (BP). However, no study has examined the 24-h urinary albumin excretion (UAE), 24-h urinary protein excretion (UPE) and 24-h ambulatory BP measurements in FM patients. The sociodemographic, laboratory parameters, depressive symptoms, sleep prob- lems and 24-h ambulatory BPs were measured for all patients. Diagnosis of FM was based on the criteria for the classification of FM by the American College of Rheumatology. After diagnosis of FM, these patients under- went to complete the Fibromyalgia Impact Questionnaire (FIQ). In total, 30 patients with FM and 61 patients without FM were included. Among FM patients, the average number of tender points was 13.1 ± 1.57 and the mean FIQ score was 57.9 ± 8.86. The number of tender points did not show any correlation with office and ambulatory BPs. There were also no correlations between the number of tender points, UPE and UAE. The stepwise linear regression did not show any relation between UPE and FM. However, 24-h UAE was independently correlated with office systolic BP (P 0.008) and the presence of FM (P 0.045). The logistic regression analysis revealed no association between FM and non-dipping status. We suggest that circadian blood pressure and UPE are not independently associated with FM. However, UAE was related with the presence of FM. Studies are needed to confirm our findings and to highlight pathophysiologic mechanisms. Keywords Blood pressure Á Albuminuria Á Fibromyalgia Á Proteinuria Introduction Fibromyalgia (FM) is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons and joints. It is also characterized by restless sleep, tiredness, fatigue, anxiety, depression and disturbances in bowel functions [1]. In rheumatology clinics, the rate of new diagnosis is approximately 10–20 %, whereas in non-specialized set- tings, the rate is 2.1–5.7 % [2, 3]. Today, the exact path- ophysiology of FM is unknown. However, research on parameters in FM indicates that multifactor’s are involved in its pathophysiology, such as genetic factors, substance P, serotonin, hypothalamic pituitary adrenal axis and muscles metabolic dysfunction [4]. However, besides these issues, recent evidence suggests that FM syndrome was associated with various pathophysiologic mechanisms and disease states including oxidative stress [5, 6], inflammation [7, 8], coronary heart disease [9], left ventricular function [10] and endothelial dysfunction [11]. Additionally, aberrant functioning of the baroreflex and autonomic dysfunction (also called dysautonomia) are commonly seen in FM patients [12, 13]. It was also known that many of the B. Afsar Division of Nephrology, Department of Internal Medicine, Konya Numune State Hospital, Konya, Turkey B. Afsar (&) Department of Nephrology, Ferhuniye Mah. Hastane Cad., Konya Numune State Hospital, 42690 Konya, Turkey e-mail: afsarbrs@yahoo.com R. Burucu Department of Nursery, Konya Numune State Hospital, Konya, Turkey 123 Rheumatol Int DOI 10.1007/s00296-013-2748-6