Out-of-office blood pressure monitoring in chronic kidney disease

Rajiv Agarwal, Aldo J. Peixoto, Sergio F F Santos, Carmine Zoccali

Research output: Contribution to journalArticle

53 Citations (Scopus)


Blood pressure (BP) control is vital to the management of patients with chronic kidney disease (CKD) yet most treatment decisions use BPs obtained in the clinic. The purpose of this report is to review the importance of self-measured and automatic ambulatory BPs in the management of patients with CKD. Compared with clinic - obtained BPs, self-measured BP more accurately defines hypertension in CKD. Masked hypertension seems to be associated with higher risk of end-stage renal disease in CKD patients. Conversely, white-coat hypertension seems to be associated with better renal outcomes than those who have persistent hypertension. Ambulatory BP monitoring is the only tool to monitor BP during sleep, diagnose nondipping, and, as self-measured BPs, have greater prognostic power in CKD compared with clinic BP. In hemodialysis patients, self-measured BP, but not pre/post-dialysis BP, shares the combination of high sensitivity and high specificity of greater than 80% to make a diagnosis of hypertension with the reference standard of ambulatory BP monitoring. In addition, self-measured and ambulatory BPs seem to be better correlates of left-ventricular hypertrophy and mortality in hemodialysis patients compared with pre/post-dialysis BP. Emerging data suggest that out-of-office BP monitoring is superior toBP obtained in the clinic when predicting target-organ damage and prognosis. Out-of-office BP monitoring is recommended for the management of hypertension in all stages of CKD.

Original languageEnglish
Pages (from-to)2-11
Number of pages10
JournalBlood Pressure Monitoring
Issue number1
StatePublished - Feb 2009


Chronic Renal Insufficiency
Blood Pressure
Ambulatory Blood Pressure Monitoring
Renal Dialysis
Masked Hypertension
White Coat Hypertension
Blood Pressure Monitors
Left Ventricular Hypertrophy
Chronic Kidney Failure
Sensitivity and Specificity


  • Ambulatory blood pressure monitoring
  • Cardiovascular disease
  • Chronic kidney disease
  • Home blood pressure monitoring
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialized Nursing

Cite this

Out-of-office blood pressure monitoring in chronic kidney disease. / Agarwal, Rajiv; Peixoto, Aldo J.; Santos, Sergio F F; Zoccali, Carmine.

In: Blood Pressure Monitoring, Vol. 14, No. 1, 02.2009, p. 2-11.

Research output: Contribution to journalArticle

Agarwal, Rajiv ; Peixoto, Aldo J. ; Santos, Sergio F F ; Zoccali, Carmine. / Out-of-office blood pressure monitoring in chronic kidney disease. In: Blood Pressure Monitoring. 2009 ; Vol. 14, No. 1. pp. 2-11.
title = "Out-of-office blood pressure monitoring in chronic kidney disease",
abstract = "Lippincott Williams & Wilkins.",
keywords = "Ambulatory blood pressure monitoring, Cardiovascular disease, Chronic kidney disease, Home blood pressure monitoring, Hypertension",
author = "Rajiv Agarwal and Peixoto, {Aldo J.} and Santos, {Sergio F F} and Carmine Zoccali",
year = "2009",
month = "2",
doi = "10.1097/MBP.0b013e3283262f58",
language = "English",
volume = "14",
pages = "2--11",
journal = "Blood Pressure Monitoring",
issn = "1359-5237",
publisher = "Lippincott Williams and Wilkins",
number = "1",



T1 - Out-of-office blood pressure monitoring in chronic kidney disease

AU - Agarwal, Rajiv

AU - Peixoto, Aldo J.

AU - Santos, Sergio F F

AU - Zoccali, Carmine

PY - 2009/2

Y1 - 2009/2

N2 - Lippincott Williams & Wilkins.

AB - Lippincott Williams & Wilkins.

KW - Ambulatory blood pressure monitoring

KW - Cardiovascular disease

KW - Chronic kidney disease

KW - Home blood pressure monitoring

KW - Hypertension

UR - http://www.scopus.com/inward/record.url?scp=63449123500&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63449123500&partnerID=8YFLogxK

U2 - 10.1097/MBP.0b013e3283262f58

DO - 10.1097/MBP.0b013e3283262f58

M3 - Article

C2 - 19194283

AN - SCOPUS:63449123500

VL - 14

SP - 2

EP - 11

JO - Blood Pressure Monitoring

JF - Blood Pressure Monitoring

SN - 1359-5237

IS - 1

ER -