Home blood pressure measurement in children and adolescents with renal replacement therapy.

Most patients with terminal renal failure show arterial hypertension. In addition to casual blood pressure measurements in the clinic, homeblood pressure measurement is recommended for these patients to control arterial blood pressure. Patients: The study was performed in children with hemodialysis (HD; n = 11), peritoneal dialysis (PD; n = 14) or after renal transplantation (NTX; n = 21) from one department of Pediatric Nephrology. We performed a retrospective analysis of home blood pressure values from patients' diaries. Methods: The average number of blood pressure measurements per day and the mean blood pressure values were calculated from the blood pressure data documented during one month at home. Single measurements above the 95th percentile for height and gender were defined to be hypertensive and the frequency as percentage of all documented values was calculated. Results: Four patients did not document any blood pressure values at home. The other patients documented an average of 2.3 measurements per day. Systolic hypertension was found in 7% of patients defined by home BP measurements compared to 30% defined by casual BP measurements. Prevalence of diastolic hypertension did not differ between both methods (35% vs. 46%). Mean home BP was significantly higher than values after HD and lower than values before HD. Mean clinic BP was significantly higher in PD-patients compared to home BP. Home and clinic blood pressure values did not differ in patients after renal transplantation. The mean percentage of hypertensive readings for systolic BP was 5 and for diastolic BP 39%. Conclusions: Blood pressure measurement at home is performed reliably by most children and adolescents with chronic renal failure and shows lower values than clinic BP in many patients. It is an important method for control of blood pressure and a valuable supplement to 24h blood pressure monitoring.