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The complex relationship between CKD and ambulatory blood pressure patterns. | LitMetric

The complex relationship between CKD and ambulatory blood pressure patterns.

Adv Chronic Kidney Dis

School of Medicine, Indiana University, Indianapolis, IN; and Department of Medicine, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN. Electronic address:

Published: March 2015

AI Article Synopsis

  • Hypertension and chronic kidney disease (CKD) often occur together, increasing the risk of cardiovascular issues and mortality.
  • Nondipping, the failure of blood pressure to fall at night, is a concern in hypertensive patients and is more common in those with CKD, affecting up to 80% of this group.
  • Ambulatory blood pressure monitoring (ABPM) is more effective than standard clinical measurements for assessing potential damage and predicting outcomes in CKD, highlighting the importance of monitoring and managing nondipping patterns.

Article 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.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586054PMC
http://dx.doi.org/10.1053/j.ackd.2015.01.003DOI Listing

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