title: [Limitations of blood pressure target in non-dialysis chronic kidney disease: a question of method?].
abstract: International guidelines recommend to reduce blood pressure (BP) levels below 130/80 mmHg in non-dialysis chronic kidney disease (CKD) patients. However, this BP target has not been validated by randomized controlled trials and is mainly driven by data obtained in observational and post-hoc analyses suggesting that it improves the renal and, to some extent, cardiovascular prognosis. The inconclusive results on the prognostic role of the BP target in patients with CKD might also relate to the limited ability of office BP readings to adequately stratify the global risk of this population. In fact, alterations of the pressure profile (such as white-coat hypertension) and nighttime hypertension are common in CKD patients. Recent studies have demonstrated that ambulatory blood pressure monitoring (ABPM) is superior to clinic BP measurements in predicting renal death and cardiovascular events. Therefore, while waiting for the results from the ongoing randomized Systolic Blood Pressure Intervention Trial (SPRINT) comparing the effect on cardiorenal prognosis of two BP target levels, the more widespread use of ABPM is desirable in CKD patients.
authors: Cattedra di Nefrologia, Seconda Universita' di Napoli, Italy. drsilvioborrelli@gmail.com
authors: Silvio
authors: S
authors: Borrelli
authors: Luca
authors: L
authors: De Nicola
authors: Roberto
authors: R
authors: Minutolo
authors: Adelia
authors: A
authors: Sagliocca
authors: Carlo
authors: C
authors: Garofalo
authors: Maria Elena
authors: ME
authors: Liberti
authors: Mario
authors: M
authors: Pacilio
authors: Valeria
authors: V
authors: Iorio
authors: Carla
authors: C
authors: Michini
authors: Laura
authors: L
authors: Pirro
authors: Giuseppe
authors: G
authors: Conte
mesh_terms: D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*