title: The complex relationship between CKD and ambulatory blood pressure patterns.
abstract: Hypertension and CKD frequently coexist, and both are risk factors for cardiovascular events and mortality. Among people with hypertension, the loss of the normal fall in night-time BP, called nondipping, can only be diagnosed by ambulatory BP monitoring (ABPM) and is a risk factor for cardiovascular events. The pathophysiology of nondipping is complex, and CKD is an independent risk factor for nondipping. In fact, nondipping can be seen in as many as 80% of people with CKD. However, the evidence for nondipping as an independent risk factor or causal agent for adverse outcomes in CKD remains mixed. ABPM has been shown to be superior to clinical BP measurement for correlating with end-organ damage and prognosis in CKD. This review covers the evidence for the use of ABPM in CKD, the evidence linking ABPM patterns to outcome in CKD and the evidence for treatment of nondipping in CKD.
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN; and Department of Medicine, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN.
authors.forename: Arjun D
authors.initials: AD
authors.lastname: Sinha
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN; and Department of Medicine, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN. Electronic address: ragarwal@iu.edu.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis; D012307:Risk Factors
keywords: Ambulatory blood pressure monitoring; Blood pressure; Chronic kidney disease; Hypertension; Nocturnal dipping