title: 44-h ambulatory blood pressure monitoring: revealing the true burden of hypertension in pediatric hemodialysis patients.
abstract: BACKGROUND
  The blood pressure (BP) burden is high in pediatric hemodialysis (HD) patients and adversely affects prognosis. The aim of this study was to examine whether 44-h ambulatory BP monitoring (ABPM) provides additional relevant BP data compared with 24-h ABPM.
  
  
  METHODS
  ABPM was initiated at the end of the mid-week dialysis run in 13 stable pediatric HD patients and continued until the next run for 44 h. Day 1 was defined as the initial 24-h ABPM and Day 2 as the time period after that until the next dialysis run. All patients had an echocardiogram to calculate the left ventricular mass index (LVMI).
  
  
  RESULTS
  A higher percentage of patients were diagnosed with hypertension from the 44-h ABPM than from the 24-h ABPM. All BP indexes and loads (except nighttime diastolic load) were significantly higher on Day 2 than on Day 1. Patients with BP loads of ≥ 25 % on 44-h ABPM had significantly higher LVMI than those patients with normal BP loads. No such association was found with 24-h ABPM and LVMI. Higher interdialytic weight gain was associated with higher Day-2 nighttime systolic BP load.
  
  
  CONCLUSIONS
  The 44-h ABPM provides more information than the 24-h ABPM in terms of diagnosing and assessing the true burden of hypertension in pediatric HD patients. Elevated BP loads from 44-h ABPM correlate with a higher LVMI on the echocardiogram.
authors.affiliation: Division of Nephrology, Department of Pediatrics, Stanford University, 300 Pasteur Drive, Room G306, Stanford, CA, 94305-5208, USA.
authors.forename: Orly
authors.initials: O
authors.lastname: Haskin
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Wong
authors.forename: Lonisa
authors.initials: L
authors.lastname: McCabe
authors.forename: Brandy
authors.initials: B
authors.lastname: Begin
authors.forename: Scott M
authors.initials: SM
authors.lastname: Sutherland
authors.forename: Abanti
authors.initials: A
authors.lastname: Chaudhuri
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008297:Male; D006435:Renal Dialysis