Key result
24-h ambulatory blood pressure monitoring identified blood pressure abnormalities not evident in clinic readings in 49% of children with chronic kidney disease stages 2-5.
Why the study?
Does 24-h ambulatory blood pressure monitoring identify blood pressure abnormalities missed by clinic readings in children with CKD?
Cross-Sectional (n=42)
Does 24-h ambulatory blood pressure monitoring identify blood pressure abnormalities missed by clinic readings in children with CKD?
24-hour ambulatory blood pressure monitoring identifies a high prevalence of masked blood pressure abnormalities, particularly nocturnal hypertension and non-dipping, in children with CKD.
May inform BP monitoring strategies in pediatric CKD; leaves open effects on clinical outcomes.
OBJECTIVES: Disturbances of blood pressure (BP) rhythms have been demonstrated in patients with various degrees of renal impairment. The purpose of this study was to determine the prevalence of BP abnormalities in children with chronic kidney disease (CKD) and evaluate possible factors associated with nocturnal BP abnormalities. METHODS: 42 children between 2 and 19 years of age with CKD stages 2-5 completed 24-h ambulatory BP monitoring. RESULTS: The percentage of patients with daytime hypertension was less than 10% but rates were higher at nighttime where 14% had systolic and 24% diastolic hypertension. A similar percentage of patients had a BP load >50%. BP abnormalities that were not evident in clinic BP readings were identified in 49% of the participants. The nocturnal BP dipping percentage tended to decrease as the estimated glomerular filtration rate decreased. Proteinuria was significantly associated with nocturnal BP nondipping. CONCLUSION: 24-h ambulatory BP monitoring may provide additional insight into hypertension in pediatric patients as early as CKD stage 2. Several BP abnormalities were identified that were not evident in casual BP measurements including nocturnal hypertension, elevated BP load, and nocturnal BP nondipping.
No takes yet. Share an insight, caveat, or question.
Dionne et al. (2008) conducted a cross-sectional in chronic kidney disease (n=42). 24-h ambulatory blood pressure monitoring was evaluated on blood pressure abnormalities not evident in clinic BP readings. 24-h ambulatory blood pressure monitoring identified blood pressure abnormalities not evident in clinic readings in 49% of children with chronic kidney disease stages 2-5.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: