Night-Time BP May Predict Risk of Kidney Failure in Children With Kidney Disease
NEW ORLEANS -- November 6, 2017 -- Monitoring blood pressure (BP) during the night may help identify children with chronic kidney disease (CKD) who are at risk of progressing to renal failure, according to a study presented at Kidney Week 2017, the Annual Meeting of the American Society of Nephrology (ASN).
Hypertension is linked with both the development and progression of CKD. Although BP is usually monitored through measurements taken at a clinic or hospital, 24-hour ambulatory BP monitoring (ABPM) provides valuable information regarding the importance of BP control throughout the day and night.
Recent studies in adults indicate that night-time high BP, independent of daytime BP, is linked with more severe end organ damage. To look at the issue in children, Mónica Guzmán-Limón, MD, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas, and colleagues analysed data from 1,195 24-hour ABPMs in children aged 1 to 16 years with mild to moderately impaired kidney function.
Children, all participants in the CKiD cohort study, were classified into 4 groups: (1) those with normal BP throughout day and night, (2) those with high BP only during the day, (3) those with high BP only at night, and (4) those with high BP during both day and night.
As in adults, children with high BP at night experienced a faster time to kidney failure when compared with children with normal BP. This decline was even more pronounced in patients with high BP during both day and night when compared with children with normal BP.
“Our study highlights the importance of normal night-time blood pressure in children with chronic kidney disease,” said Dr. Guzmán-Limón. “Night-time control of blood pressure may be an important means to delay progression of kidney disease. This study highlights the importance of ambulatory blood pressure monitoring to aid in the management of patients with chronic kidney disease.”
SOURCE: American Society of Nephrology