Blood pressure variability in chronic kidney disease patients

'Usual' blood pressure (BP) levels are known to be directly related to cardiovascular (CV) risk in the general population and patients with essential hypertension. However, there is increasing evidence that, apart from usual BP, BP variability across visits may also be an important risk factor for death and CV events in healthy subjects and in essential hypertensive patients. In chronic kidney disease (CKD) patients the relationship between hypertension and clinical outcome is still controversial. Moreover, high visit-to-visit BP variability was very recently found to predict death and CV events in this high-risk patient population. This review focuses on the available evidence about the link between high visit-to-visit BP variability and clinical outcomes in CKD patients and describes some hypothetical mechanisms that could explain such a relationship.