AMBULATORY BLOOD-PRESSURE MONITORING IS A USEFUL CLINICAL TOOL IN NEPHROLOGY

Hypertension is a key factor in the genesis and deterioration of many renal diseases and is also a risk factor for death in patients with en d-stage renal disease. However, the standard methods of measurement ar e prone to variability, especially in patients undergoing dialysis, Th e technique of ambulatory blood pressure monitoring allows a better as sessment of overall blood pressure levels and promises to assume a big ger role in the care of renal patients, Ambulatory blood pressure moni toring is widely used in hypertension trials, and the reports of sever al consensus meetings on the clinical uses of ambulatory blood pressur e monitoring have been published, Two similar validation protocols now exist for ambulatory blood pressure monitors, and tables of populatio n-based normal blood pressures for age and gender are available. The a vailable evidence suggests that ambulatory blood pressure compared wit h blood pressure measured in the physician's office is better correlat ed to left ventricular mass in subjects with chronic renal disease. Fu rthermore, studies in subjects with chronic renal disease and those un dergoing renal replacement therapy show that blood pressure control is suboptimal in many patients and that nocturnal blood pressure is gene rally higher than in control subjects. Further insights into overall b lood pressure behavior in this population will certainly emerge in the future. (C) 1997 by the National Kidney Foundation, Inc.