Cheng Wang1, Wen-Yu Gong1, Jun Zhang1, Hui Peng1, Hua Tang1, Xun Liu1, Zeng Chun Ye1, Tanqi Lou2. 1. Division of Nephrology, Department of medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China. 2. Division of Nephrology, Department of medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China. Electronic address: lou.tq@163.com.
Abstract
BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is recommended to assess hypertensive status in patients with chronic kidney disease (CKD). However, the difference in blood pressure (BP) based on clinic and ambulatory monitoring in CKD patients of different ages is not known. METHODS: We recruited 1116 CKD patients admitted to our hospital division and referred with data in this cross-sectional study. Patients were divided into three groups: young, middle age and old. Inter-method agreement between clinic BP and ABPM in different age groups was assessed using the Kappa (κ) coefficient. Linear and logistic regression analyses were used to evaluate renal and cardiovascular parameters. RESULTS: κ coefficient for inter-method agreement between clinic BP and ABP in patients from young, middle-age and old groups was 0.472 (p<0.001), 0.335 (p<0.001) and 0.102 (p=0.086), respectively. Age was the main factor determining the difference in clinic BP and ABP by multiple linear regression analyses. Prevalence of masked hypertension in older patients was higher than that in young and middle-age patients (p<0.001), and age was associated with the onset of masked hypertension. Age and ABP were independently correlated with estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI), whereas age and clinic BP were associated with carotid intima media thickness (cIMT) by linear and logistic regression analyses. CONCLUSIONS: We have provided evidence of disparate assessment of the diagnosis and correlation with TOD from clinic BP and ABP in untreated, different-aged, CKD patients. Good-quality, long-term, large longitudinal trials are needed to validate the role of ABPM for Chinese CKD patients.
BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is recommended to assess hypertensive status in patients with chronic kidney disease (CKD). However, the difference in blood pressure (BP) based on clinic and ambulatory monitoring in CKDpatients of different ages is not known. METHODS: We recruited 1116 CKDpatients admitted to our hospital division and referred with data in this cross-sectional study. Patients were divided into three groups: young, middle age and old. Inter-method agreement between clinic BP and ABPM in different age groups was assessed using the Kappa (κ) coefficient. Linear and logistic regression analyses were used to evaluate renal and cardiovascular parameters. RESULTS: κ coefficient for inter-method agreement between clinic BP and ABP in patients from young, middle-age and old groups was 0.472 (p<0.001), 0.335 (p<0.001) and 0.102 (p=0.086), respectively. Age was the main factor determining the difference in clinic BP and ABP by multiple linear regression analyses. Prevalence of masked hypertension in older patients was higher than that in young and middle-age patients (p<0.001), and age was associated with the onset of masked hypertension. Age and ABP were independently correlated with estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI), whereas age and clinic BP were associated with carotid intima media thickness (cIMT) by linear and logistic regression analyses. CONCLUSIONS: We have provided evidence of disparate assessment of the diagnosis and correlation with TOD from clinic BP and ABP in untreated, different-aged, CKDpatients. Good-quality, long-term, large longitudinal trials are needed to validate the role of ABPM for Chinese CKDpatients.
Authors: Paul E Drawz; Arnold B Alper; Amanda H Anderson; Carolyn S Brecklin; Jeanne Charleston; Jing Chen; Rajat Deo; Michael J Fischer; Jiang He; Chi-Yuan Hsu; Yonghong Huan; Martin G Keane; John W Kusek; Gail K Makos; Edgar R Miller; Elsayed Z Soliman; Susan P Steigerwalt; Jonathan J Taliercio; Raymond R Townsend; Matthew R Weir; Jackson T Wright; Dawei Xie; Mahboob Rahman Journal: Clin J Am Soc Nephrol Date: 2016-02-18 Impact factor: 8.237
Authors: Ernesto Paoletti; Luca De Nicola; Francis B Gabbai; Paolo Chiodini; Maura Ravera; Laura Pieracci; Sonia Marre; Paolo Cassottana; Sergio Lucà; Simone Vettoretti; Silvio Borrelli; Giuseppe Conte; Roberto Minutolo Journal: Clin J Am Soc Nephrol Date: 2015-12-14 Impact factor: 8.237