title: Clinical correlates of ambulatory BP monitoring among patients with CKD.
abstract: OBJECTIVE
  Ambulatory BP monitoring (ABPM) allows a better risk stratification than office BP in hypertensive patients. However, the clinical relevance of ABPM has not been extensively investigated in the CKD population.
  
  
  METHODS
  Within the Chronic Kidney Disease Japan Cohort study, 2977 patients enrolled (62% men, aged 60.8±11.6 years) and ABPM was conducted in a subgroup of patients from September 2007 to April 2010. Data from 1075 patients (682 men) were analyzed to determine BP control and factors associated with the ABPM parameters.
  
  
  RESULTS
  The prevalence of masked hypertension was 30.9%, whereas that of white-coat hypertension was 5.6%. With advancing CKD stage, the percentage of persistent hypertension increased from 21.7% to 36.1%. Diabetes, antihypertensive medicine use, and low estimated GFR (eGFR) were significantly associated with the difference between office BP and ambulatory BP (1.7 mmHg, 2.6 mmHg, and 0.6 mmHg per 10 ml/min per 1.73 m(2), respectively). There tended to be fewer nondippers and risers in stage 3 than in stages 4 and 5. In the nocturia-negative group, low eGFR, diabetes, and summer season were identified as factors associated with lower nocturnal BP change (-0.5 mmHg, -2.0 mmHg, and -2.8 mmHg, respectively). Morning BP change was greater with older age (0.2 mmHg per 10 years) and higher body mass index (0.6 mmHg per 1 kg/m(2)), and in winter (4.5 mmHg) versus summer.
  
  
  CONCLUSIONS
  Various factors including eGFR, diabetes, antihypertensive medication use, and season are associated with higher BP and abnormal BP patterns in CKD patients.
authors: Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan. siitky@gmail.com
authors: Satoshi
authors: S
authors: Iimuro
authors: Enyu
authors: E
authors: Imai
authors: Tsuyoshi
authors: T
authors: Watanabe
authors: Kosaku
authors: K
authors: Nitta
authors: Tadao
authors: T
authors: Akizawa
authors: Seiichi
authors: S
authors: Matsuo
authors: Hirofumi
authors: H
authors: Makino
authors: Yasuo
authors: Y
authors: Ohashi
authors: Akira
authors: A
authors: Hishida
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009819:Office Visits; D011237:Predictive Value of Tests; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012621:Seasons; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents