{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:42:25Z","timestamp":1787499745654,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","funder":[{"name":"T32 Ruth L. Kirschtein Institutional National Service","award":["2T32DK007219"],"award-info":[{"award-number":["2T32DK007219"]}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL131023"],"award-info":[{"award-number":["HL131023"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["DK090070"],"award-info":[{"award-number":["DK090070"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["U01-DK-66143"],"award-info":[{"award-number":["U01-DK-66143"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["U01-DK-66174"],"award-info":[{"award-number":["U01-DK-66174"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["U01DK-082194"],"award-info":[{"award-number":["U01DK-082194"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["U01-DK-66116"],"award-info":[{"award-number":["U01-DK-66116"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010511","name":"Clinical and Translational Science Institute, University of California San Francisco","doi-asserted-by":"publisher","award":["UL1 TR001872"],"award-info":[{"award-number":["UL1 TR001872"]}],"id":[{"id":"10.13039\/100010511","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Elevated BP load is part of the criteria for ambulatory hypertension in pediatric but not adult guidelines. Our objectives were to determine the prevalence of isolated BP load elevation and associated risk with adverse outcomes in children with CKD, and to ascertain whether BP load offers risk discrimination independently or in conjunction with mean ambulatory BPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>We studied 533 children in the CKD in Children (CKiD) Study to determine the prevalence of normotension, isolated BP load elevation (\u226525% of all readings elevated but mean BP normal), and ambulatory hypertension. We examined the association between these categories of BP control and adverse outcomes (left ventricular hypertrophy [LVH] or ESKD). We used c-statistics to determine risk discrimination for outcomes by BP load used either independently or in conjunction with other BP parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 23% of the cohort had isolated BP load elevation, but isolated BP load elevation was not statistically significantly associated with LVH in cross-section (odds ratio, 1.8; 95% CI, 0.8 to 4.2) or time to ESKD (hazard ratio, 1.2; 95% CI, 0.7 to 2.0). In unadjusted cross-sectional analysis, every 10% higher systolic BP load was associated with 1.1-times higher odds of LVH (95% CI, 1.0 to 1.3), but discrimination for LVH was poor (c=0.61). In unadjusted longitudinal analysis, every 10% higher systolic BP load was associated with a 1.2-times higher risk of ESKD (95% CI, 1.1 to 1.2), but discrimination for ESKD was also poor (c=0.60). After accounting for mean systolic BP, systolic BP load was not statistically significantly associated with either LVH or ESKD. Findings were similar with diastolic BP load.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BP load does not provide additive value in discriminating outcomes when used independently or in conjunction with mean systolic BP in children with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Podcast<\/jats:title>\n                    <jats:p>This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2020_03_11_CPOD10130819.mp3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.10130819","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T16:45:18Z","timestamp":1583945118000},"page":"493-500","source":"Crossref","is-referenced-by-count":40,"title":["Prognostic Value of Ambulatory Blood Pressure Load in Pediatric CKD"],"prefix":"10.2215","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9843-6694","authenticated-orcid":false,"given":"Jason","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Pediatric Nephrology, University of California San Francisco, San Francisco, California;"},{"name":"Department of Pediatrics, University of California San Francisco, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7232-7975","authenticated-orcid":false,"given":"Joseph T.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, Seattle Children\u2019s, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Samuels","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Warady","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, Children\u2019s Mercy Kansas City, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Furth","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Seth","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, University of California San Francisco, San Francisco, California;"},{"name":"Department of Pediatrics, University of California San Francisco, San Francisco, California;"},{"name":"Division of Nephrology, University of California San Francisco, San Francisco, California;"},{"name":"Department of Internal Medicine, University of California San Francisco, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Grimes","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-0250","authenticated-orcid":false,"given":"Mark M.","family":"Mitsnefes","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Ku","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, University of California San Francisco, San Francisco, California;"},{"name":"Department of Pediatrics, University of California San Francisco, San Francisco, California;"},{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California;"},{"name":"Division of Nephrology, University of California San Francisco, San Francisco, California;"},{"name":"Department of Internal Medicine, University of California San Francisco, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,3,11]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1161\/HYP.0000000000000007","article-title":"Update: Ambulatory blood pressure monitoring 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