Home blood pressure measurement in children and adolescents with renal replacement therapy.

Most patients with terminal renal failure show arterial hypertension. In ad dition to casual blood pressure measurements in the clinic, homeblood press ure measurement is recommended for these patients to control arterial blood pressure. Patients: The study was performed in children with hemodialysis (HD; n = 11), peritoneal dialysis (PD; n = 14) or after renal transplantati on (NTX; n = 21) from one department of Pediatric Nephrology. We performed a retrospective analysis of home blood pressure values from patients' diari es. Methods: The average number of blood pressure measurements per day and the mean blood pressure values were calculated from the blood pressure data documented during one month at home. Single measurements above the 95th pe rcentile for height and gender were defined to be hypertensive and the freq uency as percentage of all documented values was calculated. Results: Four patients did not document any blood pressure values at home. The other pati ents documented an average of 2.3 measurements per day. Systolic hypertensi on was found in 7% of patients defined by home BP measurements compared to 30% defined by casual BP measurements. Prevalence of diastolic hypertension did not differ between both methods (35% vs. 46%). Mean home BP was signif icantly higher than values after HD and lower than values before HD. Mean c linic BP was significantly higher in PD-patients compared to home BP. Home and clinic blood pressure values did not differ in patients after renal tra nsplantation. The mean percentage of hypertensive readings for systolic BP was 5 and for diastolic BP 39%. Conclusions: Blood pressure measurement at home is performed reliably by most children and adolescents with chronic re nal failure and shows lower values than clinic BP in many patients. It is a n important method for control of blood pressure and a valuable supplement to 24h blood pressure monitoring.