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Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population

BACKGROUND: Hypertension is a prevalent complication of Chronic Kidney Disease (CKD) and Ambulatory Blood Pressure Monitoring (ABPM) is the gold standard for diagnosis. The aim of our study was to assess the usefulness of obtaining ABPM and to identify barriers to ABPM in this pediatric patient popu...

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Autores principales: Sadiq, Sanober, Black, Elizabeth, Oates, Aris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504719/
https://www.ncbi.nlm.nih.gov/pubmed/37716957
http://dx.doi.org/10.1186/s12887-023-04304-7
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author Sadiq, Sanober
Black, Elizabeth
Oates, Aris
author_facet Sadiq, Sanober
Black, Elizabeth
Oates, Aris
author_sort Sadiq, Sanober
collection PubMed
description BACKGROUND: Hypertension is a prevalent complication of Chronic Kidney Disease (CKD) and Ambulatory Blood Pressure Monitoring (ABPM) is the gold standard for diagnosis. The aim of our study was to assess the usefulness of obtaining ABPM and to identify barriers to ABPM in this pediatric patient population. METHOD: In this retrospective analysis of patients with CKD stage 3–5 who were seen in one academic medical center’s outpatient Pediatric Nephrology clinics between 2018 and 2021, we performed logistic regression to evaluate for associations between demographic factors and odds of having an ABPM. RESULT: Among 96 patients included in the study, 48 patients carried a diagnosis of hypertension. 31 patients had ABPM performed with usable data. In those who had ABPM done, 21 had normotension and 10 had undertreated hypertension. Our study also showed 1 had masked hypertension and 5 had white coat hypertension or effect. We did not find a statistically significant difference in those who did or did not undergo ABPM evaluation based on gender, previous diagnosis of hypertension, distance from clinic, language preference, or racial or ethnic identity. CONCLUSION: ABPM is a useful tool in our CKD population for the diagnosis and management of hypertension. We did not identify specific barriers to ABPM in our CKD population, and there were no differences in patients who obtained ABPM when looking at specific demographic and disease characteristics. Given these findings, we recommend focusing on areas of future improvement in spheres of patient and provider education as well as better quantification using surveys to further illuminate barriers.
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spelling pubmed-105047192023-09-17 Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population Sadiq, Sanober Black, Elizabeth Oates, Aris BMC Pediatr Research BACKGROUND: Hypertension is a prevalent complication of Chronic Kidney Disease (CKD) and Ambulatory Blood Pressure Monitoring (ABPM) is the gold standard for diagnosis. The aim of our study was to assess the usefulness of obtaining ABPM and to identify barriers to ABPM in this pediatric patient population. METHOD: In this retrospective analysis of patients with CKD stage 3–5 who were seen in one academic medical center’s outpatient Pediatric Nephrology clinics between 2018 and 2021, we performed logistic regression to evaluate for associations between demographic factors and odds of having an ABPM. RESULT: Among 96 patients included in the study, 48 patients carried a diagnosis of hypertension. 31 patients had ABPM performed with usable data. In those who had ABPM done, 21 had normotension and 10 had undertreated hypertension. Our study also showed 1 had masked hypertension and 5 had white coat hypertension or effect. We did not find a statistically significant difference in those who did or did not undergo ABPM evaluation based on gender, previous diagnosis of hypertension, distance from clinic, language preference, or racial or ethnic identity. CONCLUSION: ABPM is a useful tool in our CKD population for the diagnosis and management of hypertension. We did not identify specific barriers to ABPM in our CKD population, and there were no differences in patients who obtained ABPM when looking at specific demographic and disease characteristics. Given these findings, we recommend focusing on areas of future improvement in spheres of patient and provider education as well as better quantification using surveys to further illuminate barriers. BioMed Central 2023-09-16 /pmc/articles/PMC10504719/ /pubmed/37716957 http://dx.doi.org/10.1186/s12887-023-04304-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Sadiq, Sanober
Black, Elizabeth
Oates, Aris
Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
title Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
title_full Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
title_fullStr Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
title_full_unstemmed Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
title_short Identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
title_sort identifying barriers and utility of obtaining ambulatory blood pressure monitoring in a pediatric chronic kidney disease population
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504719/
https://www.ncbi.nlm.nih.gov/pubmed/37716957
http://dx.doi.org/10.1186/s12887-023-04304-7
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