title: Ambulatory and home blood pressure monitoring in people with chronic kidney disease. Time to abandon clinic blood pressure measurements?
abstract: OBJECTIVE
  There is currently much interest in the usefulness of out-of-office blood pressure (BP) for the diagnosis and the management of hypertension in patients with chronic kidney disease (CKD). This is not to suggest that office BP should be disregarded and we will take the opportunity to stress how it could be improved.
  
  
  RESULTS
  Arterial hypertension constitutes a very relevant cardiovascular and renal risk factor in patients with CKD. To assess this risk, the best tool is ambulatory BP monitoring (ABPM), as it allows the detection of masked hypertension, masked untreated hypertension (MUCH) and nondipping pattern, conditions known to be associated with target organ damage that further contributes to increased risk to the patient. Home BP monitoring (HBPM) cannot fully substitute for ABPM because of the absence of BP data during the night. Despite this, there are good reasons to use HBPM systematically in patients with CKD during long-term follow-up.
  
  
  CONCLUSIONS
  In the individual patient office, BP may significantly differ from out-of-office measurements. This shortcoming can be attenuated by repeated measurement at every visit, but even if office BP is considered normal, it is still highly desirable to obtain out-of-office data.
authors.affiliation: aUnidad de Hipertensión, Instituto de Investigación i+12, Universitario Hospital 12 de Octubre bInstituto Pluridisciplinar UCM, Madrid cDepartamento de Nefrología, Hospital Universitario Central de Asturias, Oviedo, Spain dDivision of Clinical Pathphysiology, University Hospital, Lausanne, Switzerland.
authors.forename: Gema
authors.initials: G
authors.lastname: Ruiz-Hurtado
authors.forename: Manuel
authors.initials: M
authors.lastname: Gorostidi
authors.forename: Bernard
authors.initials: B
authors.lastname: Waeber
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory; D003362:Cost-Benefit Analysis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000503:physiopathology