Forty-four-hour interdialytic ambulatory blood pressure monitoring and cardiovascular risk in pediatric hemodialysis XXXX .

@entity1 @entity101 @entity4346 @entity65
BACKGROUND: @entity1 undergoing chronic hemodialysis are at risk of @entity65 and often develop @entity4346 ( @entity4346 ). Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is known to better predict @entity65 than casual blood pressure (BP) measurement. Given the BP variability attributed to interdialytic fluid overload, 44-h ABPM should @entity65 in pediatric hemodialysis @entity1 . METHODS: In this cross-sectional study, 17 @entity1 (16.7    2.9 years) on chronic hemodialysis underwent 44-h interdialytic ABPM and routine echocardiogram. Left ventricular mass index (LVMI) was calculated by height-based equation; @entity4346 was defined as an LVMI in the >= 95th percentile for height-age and gender. @entity101 was defined by the recommendations of the Fourth Report of the National High Blood Pressure Education Program for casual measurements, and by those of the American Heart Association for ABPM. RESULTS: Twenty-four percentage of @entity1 were @entity101 by casual post-dialytic systolic BP, whereas 59% were @entity101 by ABPM. Eighty-eight percentage of @entity1 had abnormal cardiac geometry: 53% had @entity4346 . Thirty-five percentage (6 of 17) had masked @entity101 , including four with abnormal cardiac geometry, of which, three had @entity4346 . LVMI correlated with ABPM, but not with casual measurements. Strongest correlations with an increased LVMI were with 44-h diastolic BP: at night (r = 0.53, P = 0.03) and total load (r = 0.57, P = 0.02). @entity4346 was similarly associated with 44-h nighttime BP: systolic (P = 0.02), diastolic (P = 0.01) and mean arterial (P = 0.01). CONCLUSIONS: Casual BP measurement underestimates @entity101 in pediatric hemodialysis @entity1 and does not correlate well with indicators of @entity65 . In contrast, 44-h interdialytic ABPM better characterizes @entity101 , with nighttime parameters most strongly predicting increased LVMI and @entity4346 .
