44-h ambulatory blood pressure monitoring: revealing the true burden of hypertension in pediatric hemodialysis patients.
Pediatr Nephrol
; 30(4): 653-60, 2015 Apr.
Article
in En
| MEDLINE
| ID: mdl-25266709
ABSTRACT
BACKGROUND:
The blood pressure (BP) burden is high in pediatric hemodialysis (HD) patients and adversely affects prognosis. The aim of this study was to examine whether 44-h ambulatory BP monitoring (ABPM) provides additional relevant BP data compared with 24-h ABPM.METHODS:
ABPM was initiated at the end of the mid-week dialysis run in 13 stable pediatric HD patients and continued until the next run for 44 h. Day 1 was defined as the initial 24-h ABPM and Day 2 as the time period after that until the next dialysis run. All patients had an echocardiogram to calculate the left ventricular mass index (LVMI).RESULTS:
A higher percentage of patients were diagnosed with hypertension from the 44-h ABPM than from the 24-h ABPM. All BP indexes and loads (except nighttime diastolic load) were significantly higher on Day 2 than on Day 1. Patients with BP loads of ≥ 25 % on 44-h ABPM had significantly higher LVMI than those patients with normal BP loads. No such association was found with 24-h ABPM and LVMI. Higher interdialytic weight gain was associated with higher Day-2 nighttime systolic BP load.CONCLUSIONS:
The 44-h ABPM provides more information than the 24-h ABPM in terms of diagnosing and assessing the true burden of hypertension in pediatric HD patients. Elevated BP loads from 44-h ABPM correlate with a higher LVMI on the echocardiogram.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Blood Pressure
/
Renal Dialysis
/
Blood Pressure Monitoring, Ambulatory
/
Hypertension
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Female
/
Humans
/
Male
Language:
En
Journal:
Pediatr Nephrol
Journal subject:
NEFROLOGIA
/
PEDIATRIA
Year:
2015
Document type:
Article
Affiliation country:
United States