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The complex relationship between CKD and ambulatory blood pressure patterns

Arjun D Sinha1, Rajiv Agarwal1

  • 1School of Medicine, Indiana University, Indianapolis, IN; and Department of Medicine, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN.

Advances in Chronic Kidney Disease
|February 24, 2015
PubMed

Insights

Ambulatory blood pressure monitoring (ABPM) is crucial for diagnosing nondipping in hypertension patients with chronic kidney disease (CKD). This review examines ABPM

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Management

Background:

  • Hypertension and chronic kidney disease (CKD) frequently coexist, increasing cardiovascular risks.
  • Nondipping, a loss of the normal nighttime blood pressure fall, is diagnosed by ambulatory blood pressure monitoring (ABPM) and is a cardiovascular risk factor.
  • CKD is an independent risk factor for nondipping, observed in up to 80% of patients.

Purpose of the Study:

  • To review the evidence for using ABPM in CKD patients.
  • To examine the link between ABPM patterns and patient outcomes in CKD.
  • To assess the evidence for treating nondipping in CKD.

Main Methods:

  • Literature review of studies on ABPM in CKD.
  • Analysis of evidence linking ABPM-derived hypertension patterns to CKD prognosis.
  • Evaluation of treatment strategies for nondipping in the context of CKD.

Main Results:

  • ABPM is superior to clinical BP measurement for correlating with end-organ damage and prognosis in CKD.
  • Nondipping is highly prevalent in CKD patients.
  • Evidence linking nondipping to adverse outcomes in CKD is mixed, necessitating further research.

Conclusions:

  • ABPM is a valuable tool for assessing cardiovascular risk in CKD patients.
  • Further research is needed to clarify the independent prognostic role of nondipping in CKD.
  • Optimizing ABPM use and treatment of nondipping may improve CKD outcomes.

Keywords:
Ambulatory blood pressure monitoringBlood pressureChronic kidney diseaseHypertensionNocturnal dipping

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