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Pediatric Nephrology

, Volume 30, Issue 4, pp 653–660 | Cite as

44-h ambulatory blood pressure monitoring: revealing the true burden of hypertension in pediatric hemodialysis patients

  • Orly Haskin
  • Cynthia J. Wong
  • Lonisa McCabe
  • Brandy Begin
  • Scott M. Sutherland
  • Abanti Chaudhuri
Original Article

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.

Keywords

Hypertension Dialysis Pediatric nephrology Blood pressure Ambulatory blood pressure monitoring 

Notes

Acknowledgments

This work is supported by the Stanford CTSA (UL1 RR025744) “The Paul and Yuanbi Ramsay Endowed Postdoctoral Fellow”.

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Copyright information

© IPNA 2014

Authors and Affiliations

  • Orly Haskin
    • 1
  • Cynthia J. Wong
    • 1
  • Lonisa McCabe
    • 2
  • Brandy Begin
    • 2
  • Scott M. Sutherland
    • 1
  • Abanti Chaudhuri
    • 1
  1. 1.Division of Nephrology, Department of PediatricsStanford UniversityStanfordUSA
  2. 2.Lucile Packard Children’s Hospital StanfordPalo AltoUSA

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