Ambulatory blood pressure monitoring in hemodialysis patients: a critique and literature review.
Ambulatory blood pressure (ABP) monitoring has been in use for nearly four decades. In that time, the advantages of using a more reproducible and accurate method to assess the true contribution of blood pressure to the cardiovascular risk profile of patients have steadily become more clearly established, balanced by the additional expense and expertise involved. In nephrology, and in particular in dialysis patients, there are significant difficulties in accurately registering truly representative blood pressure values and understanding the relationship between blood pressure, end-organ damage, and patient mortality. This arises because of the way in which hemodialysis acutely changes blood pressure values as well as the widespread abnormality of diurnal blood pressure rhythm seen in dialysis patients. Use of ABP monitoring can go some way to overcoming these obstacles. In this review we critically examine the use of ABP monitoring in the understanding of blood pressure control in dialysis patients.
Covic
Adrian
A
Renal Unit, Parhon Hospital, Iasi, Romania.
Haydar
Ali A
AA
Goldsmith
David
D
D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects