Background: It is now hypothesized that the Ambulatory Blood Pressure Measurement (ABPM) method in determining and controlling blood pressure and renal disease-related cardiac defects in children with renal impairment can be more applicable. We aimed to compare the mean blood pressure measured by the ABPM method with blood pressure measured by the auscultation method in determining cardiovascular complications by measuring left ventricular mass index (LVMI) in children with chronic kidney disease.
Methods: This cross-sectional study was performed on 40 children suffering from chronic kidney disease referred to Mofid Children Hospital in Tehran between 2019 and 2021. Each child was evaluated during the first 24 hours, every 20 minutes during the day, and every 30 minutes during the night, and blood pressure was assessed by the ABPM method and every 3 hours by the auscultation method. Patients also underwent echocardiography to determine LVMI.
Results: Based on the assessment by auscultation method, 47.0% of children suffered from systolic hypertension, and 40.0% had diastolic hypertension. In total, 50% were hypertensive. According to ABPM blood pressure data, 23 patients (57%) had systolic hypertension and 24 patients (60%) had diastolic hypertension. In total, 16 patients (40%) had normal blood pressure and 24 patients (60%) had hypertension by the ABPM method. Also, according to ABPM measurement, 10 patients (25%) suffered from masked hypertension, and 6 patients (15%) from white-coat hypertension. There was a significant association between LVMI and the blood pressures assessed by the ABPM method.
Conclusion: Auscultation blood pressure measurement alone may not be sufficient to diagnose hypertension in patients with chronic kidney disease. It should be used in conjunction with the ABPM method.