title: Discrepancies in Clinic and Ambulatory Blood Pressure in Korean Chronic Kidney Disease Patients.
abstract: Blood pressure (BP) control is considered the most important treatment for preventing chronic kidney disease (CKD) progression and associated cardiovascular complications. However, clinic BP is insufficient to diagnose hypertension (HT) and to monitor overall BP control because it does not correlate well with ambulatory blood pressure monitoring (ABPM). We enrolled 387 hypertensive CKD patients (stages G1-G4, 58.4% male with median age 61 years) from 3 hospitals in Korea. HT of clinic BP and ABPM was classified as ≥ 140/90 and ≥ 130/80 mmHg, respectively. Clinic BP control rate was 60.2%. The median 24-hour systolic blood pressures (SBPs) of CKD G3b and CKD G4 were significantly higher than those of CKD G1-2 and CKD G3a. However, the median 24-hour SBPs were not different between CKD G1-2 and CKD G3a or between CKD G3b and CKD G4. Of all patients, 5.7%, 38.0%. 42.3%, and 14.0% were extreme-dippers, dippers, non-dippers, and reverse-dippers, respectively. Non-/reverse-dippers independently correlated with higher Ca × P product, higher intact parathyroid hormone (iPTH), and lower albumin. Normal BP was 33.3%, and sustained, masked, and white-coat HT were 29.7%, 26.9%, and 10.1%, respectively. White-coat HT independently correlated with age ≥ 61 years and masked HT independently correlated with CKD G3b/G4. In conclusion, ABPM revealed a high prevalence of non-/reverse-dippers and sustained/masked HT in Korean CKD patients. Clinicians should try to obtain a CKD patient's ABPM, especially among those who are older or who have advanced CKD as well as those with abnormal Ca × P product, iPTH, and albumin.
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Yun Kyu
authors.identifier: http://orcid.org/0000-0001-8632-5743
authors.initials: YK
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ho Jun
authors.identifier: http://orcid.org/0000-0003-1185-2631
authors.initials: HJ
authors.lastname: Chin
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Shin Young
authors.identifier: http://orcid.org/0000-0002-6844-0614
authors.initials: SY
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Jung Nam
authors.identifier: http://orcid.org/0000-0001-5108-1005
authors.initials: JN
authors.lastname: An
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Jung Pyo
authors.identifier: http://orcid.org/0000-0002-4714-1260
authors.initials: JP
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Chun Soo
authors.identifier: http://orcid.org/0000-0001-9123-6542
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. khoh@snu.ac.kr.
authors.forename: Kook Hwan
authors.identifier: http://orcid.org/0000-0001-9525-2179
authors.initials: KH
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005919:Glomerular Filtration Rate; D006761:Hospitals; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010281:Parathyroid Hormone / Q000032:analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000473:pathology*; D056910:Republic of Korea; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone
keywords: Ambulatory Blood Pressure Monitoring; Blood Pressure; Chronic Kidney Disease; Hypertension; Masked Hypertension; White-Coat Hypertension