Clinical Utility of 24-h Ambulatory Blood Pressure Monitoring in Hospitalized Patients with Chronic Kidney Disease

Clinical Utility of 24-h Ambulatory Blood Pressure Monitoring in Hospitalized Patients with Chronic Kidney Disease

Introduction: Hypertension leads to rapid progression of kidney disease. Hypertension (HTN) is the second most common cause for CKD after diabetes. Ambulatory blood pressure monitoring (ABPM) helps in accurate and early diagnosis of HTN along with measurements of other variables, namely nondippers,...

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Published in:Indian journal of nephrology Vol. 31; no. 4; pp. 365 - 369
Main Authors: Salagre, Santosh, Ansari, Nigarbi, Mali, Vandana
Format: Journal Article
Language:English
Published: India Wolters Kluwer India Pvt. Ltd 01-07-2021
Medknow Publications and Media Pvt. Ltd
Scientific Scholar
Wolters Kluwer - Medknow
Subjects:
Age groups
Blood pressure
Chronic kidney failure
Development and progression
Ethical aspects
Health aspects
Hemodialysis
Hospital patients
Hypertension
Kidney diseases
Measurement
Medical research
Medicine, Experimental
Original
Patient monitoring equipment
chronic kidney disease
clinical utility
Ambulatory blood pressure monitoring
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Summary:Introduction: Hypertension leads to rapid progression of kidney disease. Hypertension (HTN) is the second most common cause for CKD after diabetes. Ambulatory blood pressure monitoring (ABPM) helps in accurate and early diagnosis of HTN along with measurements of other variables, namely nondippers, reverse dippers, hyperbaric index (HBI), percentage time elevation (PTE), and early morning surge. Methodology: After obtaining the institution ethics committee approval total 192 cases, of 12-80 years age group, who were diagnosed with CKD were included in the study. ABPM was done for patients using Meditech ABPM-05 machine. Results: Study showed male predominance. Maximum patients were in the age group of 41-60 years. Prevalence of Hypertension in patients with CKD was 88.02%. The systolic BP, diastolic BP, and mean arterial pressure (MAP) were significantly higher by clinic BP measurement than ABPM in all stages of patients with CKD especially in stage IV than stage V CKD. Systolic, diastolic, MAP, HBI and PTE at nighttime were significantly higher than daytime in all patients with CKD, especially in patients with resistant hypertension. Prevalence of whitecoat HTN (4.1%), whitecoat effect (16.1%), resistant hypertension (39.6%), masked HTN (1%), and masked uncontrolled HTN (10.4%) was noted. Systolic and diastolic HBI was lower in patients on hemodialysis as compared to those not on hemodialysis. Non-dippers were more than dippers. Conclusion: Apart from mean systolic and diastolic BP, ABPM gives the extent of end-organ damage and insights into the need for control of 24 h BP in patients of CKD.
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ISSN:0971-4065
1998-3662
DOI:10.4103/ijn.IJN_394_19