Ambulatory blood pressure monitoring in chronic renal disease: technical aspects and clinical relevance.
OBJECTIVE
To evaluate the current value of ambulatory blood pressure monitoring in patients with chronic renal disease and end-stage renal disease.


RESULTS
Ambulatory blood pressure monitoring has become an important tool in hypertension research and clinical practice. Its use in essential hypertension shows a strong predictive ability in the assessment of cardiovascular outcomes. In chronic renal failure and end-stage renal disease, the role of ambulatory blood pressure monitoring is still being actively evaluated, and available evidence shows that it is better than office blood pressure in predicting left ventricular hypertrophy and progression of renal dysfunction in patients with chronic renal failure. In end-stage renal disease, preliminary data suggest better prediction of mortality in hemodialysis patients in comparison with clinic blood pressures. The most conspicuous problems with the literature on this subject are small sample sizes and the paucity of longitudinal observational studies and intervention trials.


CONCLUSIONS
Preliminary data and extrapolations from essential hypertension have justified a growing excitement about the use of ambulatory blood pressure monitoring in renal disease. However, further research will have to address the limitations of the available literature before generalization of its use is implemented.
Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut, USA. aldo.peixoto@yale.edu
Aldo J
AJ
Peixoto
William B
WB
White
D018660:Blood Pressure Monitoring, Ambulatory; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D007674:Kidney Diseases / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D006435:Renal Dialysis