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Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease

Hypertension is common in children with chronic kidney disease (CKD) and is a major determinant of CKD progression. Ambulatory blood pressure monitoring (ABPM) has been proposed to be better in detecting hypertension as compared to casual blood pressure (CBP). This study aims to study the usefulness...

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Autores principales: Gupta, D., Chaturvedi, S., Chandy, S., Agarwal, I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663773/
https://www.ncbi.nlm.nih.gov/pubmed/26664211
http://dx.doi.org/10.4103/0971-4065.148305
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author Gupta, D.
Chaturvedi, S.
Chandy, S.
Agarwal, I.
author_facet Gupta, D.
Chaturvedi, S.
Chandy, S.
Agarwal, I.
author_sort Gupta, D.
collection PubMed
description Hypertension is common in children with chronic kidney disease (CKD) and is a major determinant of CKD progression. Ambulatory blood pressure monitoring (ABPM) has been proposed to be better in detecting hypertension as compared to casual blood pressure (CBP). This study aims to study the usefulness of ABPM in detecting masked hypertension, evaluating the adequacy of blood pressure (BP) control and predicting left ventricular hypertrophy (LVH) amongst children with CKD. A prospective cross-sectional study of 46 children with stage 3–5 CKD was conducted at the Pediatric Nephrology department of a tertiary hospital in South India. All children underwent CBP, ABPM and an echocardiography. Results were categorized as normal BP; confirmed hypertension; masked hypertension and white coat hypertension. Out of 46 children studied, 11 were undergoing dialysis. While 39.1% children had stage 3 and 4 CKD each, 21.7% had stage 5 CKD. Masked hypertension was detected in 19.6% and 21.7% had confirmed hypertension. Thirty-four (73.9%) children were already receiving antihypertensive medication. In these, CBP was elevated in 23.5% and ABP in 47%. Among children with hypertension as defined by ABPM, LVH was detected in 32.2%. We found that higher the number of abnormal ABPM indices (assessed by BP Index, nocturnal dipping and BP Load) higher the likelihood of LVH (P = 0.046). ABPM is better in detecting hypertension and monitoring adequacy of treatment in children with CKD. The high prevalence of masked hypertension and its association with LVH supports early echocardiography and ambulatory BP monitoring to evaluate cardiovascular risks in this population.
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spelling pubmed-46637732015-12-10 Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease Gupta, D. Chaturvedi, S. Chandy, S. Agarwal, I. Indian J Nephrol Original Article Hypertension is common in children with chronic kidney disease (CKD) and is a major determinant of CKD progression. Ambulatory blood pressure monitoring (ABPM) has been proposed to be better in detecting hypertension as compared to casual blood pressure (CBP). This study aims to study the usefulness of ABPM in detecting masked hypertension, evaluating the adequacy of blood pressure (BP) control and predicting left ventricular hypertrophy (LVH) amongst children with CKD. A prospective cross-sectional study of 46 children with stage 3–5 CKD was conducted at the Pediatric Nephrology department of a tertiary hospital in South India. All children underwent CBP, ABPM and an echocardiography. Results were categorized as normal BP; confirmed hypertension; masked hypertension and white coat hypertension. Out of 46 children studied, 11 were undergoing dialysis. While 39.1% children had stage 3 and 4 CKD each, 21.7% had stage 5 CKD. Masked hypertension was detected in 19.6% and 21.7% had confirmed hypertension. Thirty-four (73.9%) children were already receiving antihypertensive medication. In these, CBP was elevated in 23.5% and ABP in 47%. Among children with hypertension as defined by ABPM, LVH was detected in 32.2%. We found that higher the number of abnormal ABPM indices (assessed by BP Index, nocturnal dipping and BP Load) higher the likelihood of LVH (P = 0.046). ABPM is better in detecting hypertension and monitoring adequacy of treatment in children with CKD. The high prevalence of masked hypertension and its association with LVH supports early echocardiography and ambulatory BP monitoring to evaluate cardiovascular risks in this population. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4663773/ /pubmed/26664211 http://dx.doi.org/10.4103/0971-4065.148305 Text en Copyright: © Indian Journal of Nephrology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Gupta, D.
Chaturvedi, S.
Chandy, S.
Agarwal, I.
Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
title Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
title_full Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
title_fullStr Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
title_full_unstemmed Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
title_short Role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
title_sort role of 24-h ambulatory blood pressure monitoring in children with chronic kidney disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663773/
https://www.ncbi.nlm.nih.gov/pubmed/26664211
http://dx.doi.org/10.4103/0971-4065.148305
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