Practical application of ABPM in the pediatric nephrology clinic

Halbach, Susan M.

doi:10.1007/s00467-019-04361-0

Cited by 12 publications

(5 citation statements)

References 74 publications

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“…14 In different studies, the frequency of WCT varies between 7% and 52% in patients referred for high BP. 11,24,25 Venettacci et al evaluated the compatibility and inconsistency of both guidelines on ABPM diagnoses, and found that masked HT was prominent in the ESH guideline and white coat HT was prominent in the AAP guideline. 26 Adult studies emphasise that approximately half of the patients with WCT had sustained HT at a 10-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of ESHG₂₀₁₆ and AAP₂₀₁₇ hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

et al. 2021

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Objective: The diagnosis of hypertension in adolescents aged ≥13 and <16 years is based on the percentile according to age, gender, and height in the European Society of Hypertension guidelines guideline; whereas, the American Academy of Pediatrics guideline uses blood pressure above 130/80 mmHg as a single criterion. Therefore, this study aimed to evaluate the compatibility of these two guidelines in adolescents aged ≥13 and <16 years. Methods: This study was designed by retrospectively screening the records of 395 adolescents with both office and 24-hour ambulatory blood pressure measurements. Each blood pressure measurement was classified according to both the ESGH2016 and AAP2017 guidelines. Patients were divided into three subgroups according to body mass index. Cohen’s kappa analysis was used to evaluate the agreement between the two guidelines. Results: The majority of adolescents were normotensive according to both guidelines, 55.9% by ESHG2016 and 43.1% by AAP2017. For the whole group, the frequency of hypertension was 32.4% with ESHG2016 and 34.4% with AAP2017; while, in obese patients, hypertension frequencies were 38.8% and 43.3%, respectively. The diagnosis of hypertension was demonstrated with the two guidelines, and there was significant agreement at a substantial level, both for the obese subgroup and the whole study group (kappa value = 0.738 and 0.785, respectively). The frequency of white-coat hypertension was higher with the AAP2017 guideline (28.1% versus 16.2%, p < 0.001). Conclusion: With our experience in this single-centre study, it seems that both the AAP2017 and the ESHG2016 guidelines can be used in the diagnosis of hypertension in adolescents.

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Section: Discussionmentioning

confidence: 99%

“…10 Four subgroups were created with office BP and ABPM measurements; normotension, hypertension, white-coat hypertension, and masked HT. 11,12 The definitions of these definitions were presented in detail in Table 1.…”

Section: Office Blood Pressure Measurementsmentioning

confidence: 99%

Comparison of ESHG₂₀₁₆ and AAP₂₀₁₇ hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

et al. 2021

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“…The CKD Task Force judged that there was no reason to suspect differences in feasibility regarding the availability of antihypertensive treatments in Saudi Arabia. • Implementation: The 2021 KDIGO guideline [8] reported that implementing ABPM for monitoring the treatment of hypertension is challenging [27]. For instance, blood pressure monitors are not always available when needed; they require time from a parent or other adult to return the monitor to the clinic; they are expensive; and in certain situations, there is a low probability of finding elevated blood pressure using ABPM, such as children with clinic blood pressure at <25th percentile.…”

Section: Resource Use and Cost-effectivenessmentioning

confidence: 99%

Adapting Clinical Practice Guidelines for Chronic Kidney Disease: Blood Pressure Management and Kidney Replacement Therapy in Adults and Children in the Saudi Arabian context using the GRADE-ADOLOPMENT methodology

Alhasan¹,

Yepes-Núñez²,

Askandarani³

et al. 2023

Preprint

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Background: This practice guideline was developed by the Chronic Kidney Disease (CKD) Task Force, which was composed of clinical and methodological experts. The Saudi Arabian Ministry of Health and its Health Holding Company commissioned this guideline project to support the realization of the Vision 2030's healthcare transformation pillar. Methods: The guideline synthesis was guided by the GRADE-ADOLOPMENT methodology. Results: The final adoloped guideline addressed 12 clinical questions on blood pressure management in patients with CKD through a set of recommendations and performance measures. The recommendations included antihypertensive agents in children, non-renin angiotensin system inhibition (Non-RASi) vs RASi in adults, intensive vs standard blood pressure targets, early vs late assessment for kidney replacement therapy (KRT), late vs early preparation strategy for KRT, CKD symptoms during assessment for KRT or conservative management, initiation of KRT in patients with deteriorating CKD, choice of KRT modality or conservative management in certain CKD patient groups, changing or discontinuing KRT modalities, review frequency for KRT or conservative management, and Information, education and support. Conclusions: These conditional recommendations were based on low to very low certainty of evidence that highlights the need for high-quality randomized trials comparing different antihypertensive agents in patients with CKD.

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“…There are many children with CKD who have normal BPs on ABPM, but elevated BP loads (>25%) [ 26 , 35 ]. However, whether elevated BP loads predict either target organ damage or CV events independently of ambulatory BP remains unclear, not only in children but also in adults [ 38 , 39 ].…”

Section: Cardiovascular Risks and Biomarkers In Pediatric Ckdmentioning

confidence: 99%

Cardiovascular Risks of Hypertension: Lessons from Children with Chronic Kidney Disease

Tain

Hsu²

2022

Children

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Hypertension is the most common complication of chronic kidney disease (CKD) in children, having a strong association with subsequential cardiovascular disease (CVD). In pediatric CKD, a considerable percentage of children with hypertension are undiagnosed or undertreated. Prior research has evaluated structural and functional markers of subclinical CVD and biomarkers in adults with CKD, while ideal biomarkers in pediatrics are still insufficiently studied. The ultimate goal of this review is to summarize what is currently known about state of hypertension, cardiovascular risk factors, and potential CVD markers/biomarkers in children with pre-dialysis CKD. We discuss omics-related biomarkers and the pathophysiologic processes of endothelial dysfunction, kidney injury, oxidative stress and inflammation that are classified by specific biomarkers. Moreover, we illustrate the existing challenges and highlight the paucity of pediatric CKD research to evaluate these CVD biomarkers for future clinical pediatric practice. Thus, achieving clinical utility of CVD biomarkers for use in pediatric CKD remains a significant challenge requiring additional efforts.

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Practical application of ABPM in the pediatric nephrology clinic

Cited by 12 publications

References 74 publications

Comparison of ESHG₂₀₁₆ and AAP₂₀₁₇ hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Comparison of ESHG₂₀₁₆ and AAP₂₀₁₇ hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Adapting Clinical Practice Guidelines for Chronic Kidney Disease: Blood Pressure Management and Kidney Replacement Therapy in Adults and Children in the Saudi Arabian context using the GRADE-ADOLOPMENT methodology

Cardiovascular Risks of Hypertension: Lessons from Children with Chronic Kidney Disease

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Practical application of ABPM in the pediatric nephrology clinic

Cited by 12 publications

References 74 publications

Comparison of ESHG2016 and AAP2017 hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Comparison of ESHG2016 and AAP2017 hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Adapting Clinical Practice Guidelines for Chronic Kidney Disease: Blood Pressure Management and Kidney Replacement Therapy in Adults and Children in the Saudi Arabian context using the GRADE-ADOLOPMENT methodology

Cardiovascular Risks of Hypertension: Lessons from Children with Chronic Kidney Disease

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Product

Resources

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Comparison of ESHG₂₀₁₆ and AAP₂₀₁₇ hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines

Comparison of ESHG₂₀₁₆ and AAP₂₀₁₇ hypertension guidelines in adolescents between the ages of 13 and 16: effect of body mass index on guidelines