24 Hour Ambulatory Blood Pressure Monitoring In Patients With Chronic Kidney Disease

Abstract

Background and aims: Chronic Kidney Disease (CKD) And Hypertension(HTN) Are  Associated With Each Other Invariably And Each Can Cause Or Aggravate The  Other.Hypertension Is A Strong Independent Risk Factor For ESRD And Contributes To The  Disease Itself, Or Most Commonly, To Its Progression.24 Hour Ambulatory Blood Pressure  Monitoring (ABPM) Is Superior To Clinic BP Monitoring In Predicting The Risk In  Hypertensive CKD Patients The Aim Of This Study Was To Review The Results Of  ABPM In CKD Patients Which Can Guide In Changing The Antihypertensive Therapy . Material and Methods: This Prospective Observational Study Having 63 Patients. All The _{Patients Fulfilling The Criteria Of CKD According To The KDIGO Guidelines} And Above  18 Years Of Age Were Included In This Study Whose 24 Hour Ambulatory Blood  Pressure Was Measured.Detailed History, Clinical Examination And Relevant  Investigations Were Recorded Comparisons Of Various ABPM Characteristics WERE  Done And P Value <0.005 Was Considered Significant. Results: Out Of 63 Patients (M:38,F:25)Maximum Patients (25.39%)Were In Age Group  61-70 Years (M:61-70,F:41-45).51(80.95%)Patients Were On Dialysis And 12  (19.04%)Patients Were Not On Dialysis. In This Study 57 Patients Had Hypertension,  44 Had DM,16 Had IHD.In This Study 2(3.17%) Patients Were CKD Stage I,5(7.93%) Were  Stage II,1(1.58%) Was Stage lll, 6(9.52%) Were Stage IV And 49 (77.77%) Were Stage V.Out Of  Total 16(25.39%) Patients Were Dippers ,21 (33.33%) Were Non Dippers, 21(33.33%) Were  Reverse Dippers And 5 (7.93%) Were Extreme Dippers..Mean ABPM Systolic BP ,Mean  ABPM Diastolic BP,Mean PTA Systolic BP,Mean Arterial Pressure Were Significantly  Higher In Male Patients which were On Dialysis Than Patient Not On Dialysis. Conclusion: ABPM is Superior Than Clinical Bp Monitoring In Predicting The Future  Communications In CKD Patients Especially PTE,HBI MAP And Other Parameter To Guide To  Formulate Treatment Protocol Identifying Such Patients Of Hypertension In Earlier Stages Of  CKD,Helped In Morbidity Outcomes While Identifying In Later Stages Of CKD Helped In Mortality  Benefits.