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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
Ahead of Print

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


 Department of Medicine, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Santosh B Salagre,
Department of Medicine, Seth G.S Medical College and KEM Hospital, Acharya Donde Road, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_394_19

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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    -  Salagre SB
    -  Ansari NN
    -  Mali VS
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Indian Journal of Nephrology
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Online since 20th Sept '07