Appendix 1: methods used for guideline development   American Journal of Kidney Diseases  Volume 43, Pages 231-261 (May 2004) DOI: 10.1053/j.ajkd.2004.03.008

Fig 62 The evolution of National Kidney Foundation Guidelines on Hypertension and Antihypertensive Agents in CKD. American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 63 Comparison of the diagnosis of hypertension using casual blood pressure and ambulatory blood pressure monitoring. Figure compares the diagnosis of hypertension made by CBP and ABPM in 573 patients. Area 1 represents WCH; Area 2 represents true hypertensives; Area 3 represents true normotensives; Area 4 represents masked hypertension.598a American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 64 Standardized common patterns of ABPM. Standardized common patterns of ABPM (ECF Medicatl Ltd., Blackrock, Co. Dublin, Ireland, www.ecfmedical.com). Common to all plots: vertical axes show blood pressures; horizontal axes shot 24-hour clock × horizontal bands indicate normal values for 24-hour SBP and DBP; shaded vertical areas indicate night-time. (A) Normal ABPM pattern. This ABPM suggests normal 24-hour SBP and DBP (128/78 mm Hg daytime, 110/62 night-time), (B) White-coat hypertension. This ABPM suggest WCH (175/95 mm Hg) with otherwise normal 24-hour SBP and DBP (133/71 mm Hg daytime, 119/59 mm Hg night-time). (C) White-coat effect. This ABPM suggests mild daytime systolic hypertension (149 mm Hg), borderline daytime diastolic hypertension (87 mm Hg), borderline night-time systolic hypertension (121 mm Hg), and normal night-time DBPs (67 mm Hg) with white-coat effect (187/104 mm Hg). (D) Systolic and diastolic hypertension. This ABPM suggests mild daytime systolic and diastolic hypertension (147/93 mm Hg), but normal night-time SBP and DBP (111/66 mm Hg). (E) Isolated systolic hypertension. This ABPM suggests severe 24-hour isolated systolic hypertension (176/68 mm Hg daytime, 169/70 mm Hg night-time). (F) Hypertensive dipper. This ABPM suggests severe daytime systolic hypertension (181 mm Hg), moderate daytime diastolic hypertension (117 mm Hg) and normal night-time SBP and DBP (111/68 mm Hg). (G) Hypertensive nondipper. This ABPM suggest severe 24-hour systolic and diastolic hypertensive (210/134 mm Hg daytime, 205/130 mm Hg night-time). American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 65 Blunting of the diurnal blood pressure rhythm of predialysis patients is more severe at lower GFR (higher serum creatinine concentration). To convert to mg/dL, divide by 88.4. Reproduced with permission.604 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 66 Kaplan-Meier curves showing the probability of developing CKD (microalbuminuria) according to the pattern of daytime and nighttime systolic pressure in diabetes. The probability of microalbuminuria differed significantly between the two groups (P = 0.01 by the log-rank test; chi-square = 6.217 with 1 df). The risk of microalbuminuria was 70% lower in the subjects with a normal nocturnal pattern than in those with an abnormal nocturnal pattern.179 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 67 Survival curves of diabetic subjects with normal (N) and reversed (R) circadian blood pressure rhythms. The unadjusted relative risk for diabetic subjects with a reversed circadian blood pressure rhythm was 20.6-fold higher than that of subjects with a normal rhythm (P < 0.001; Cox-Mantel’s test).183 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 68 Relationship between end-systolic left ventricular diameter and percent fall in blood pressure (sleep to awake) in hemodialysis patients and kidney transplant recipients. The less the fall in blood pressure during sleep, the more dilated the LV chamber. Reproduced with permission.618 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 69 Night to day blood pressure ratio and 24-hour SBP at entry as predictors of the 2-year incidence of cardiovascular end-points in 393 patients randomized to the placebo group of the Systolic Hypertension in Europe Trial. Using Cox regression analysis, the event rate was standardized to female sex, mean age (69.6 years), a lack of previous cardiovascular complications, nonsmoking status, and residence in Western Europe. Incidence is given as the probability of an event per 100 patients. Reproduced with permission.600 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 70 Diurnal blood pressure rhythm in diabetic kidney disease. Comparison of two groups of patients with diabetic kidney disease matched for daytime blood pressure, cholesterol, proteinuria and diabetic control—one cohort (left) with normal diurnal blood pressure, and an average creatinine clearance decline of 2.9 mL/min compared to the other cohort (right) with abnormal diurnal blood pressure, and a rate of creatinine clearance decline of 7.9 mL/min. Reproduced with permission.182 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 71 Correlation of creatinine values in patients 6 months after kidney transplantation with 24-hour SBP (left) and DBP (right). Reproduced with permission.620 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 72 Rates of major cardiovascular events in a normotensive group (A), two groups with WCH defined using restrictive (B) or liberal (C) criteria, and a group with ambulatory hypertension (D). Reproduced with permission.621,622 American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)

Fig 73 Comparison of cuff blood pressure, 24-hour ABPM, and night-time ABP in the HOPE Study and a HOPE Substudy. American Journal of Kidney Diseases 2004 43, 231-261DOI: (10.1053/j.ajkd.2004.03.008)