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Abstract：
High blood pressure is an important risk factor for cardiovascular disease and disease progression in chronic kidney disease (CKD). Evidence on the effects of home blood pressure monitoring (HBPM) is limited. This review aimed to determine the effect of HBPM on systolic (SBP) and diastolic blood pressure (DBP) in patients with CKD. We searched medical literature databases for eligible studies presenting pre- and post-data for interventions utilizing HBPM. Study quality was assessed using the NHLBI tools for quality assessment. Heterogeneity prohibited a meta-analysis so estimates of effects were calculated along a sign test to examine the probability of observing the given pattern of positive effect direction. Eighteen studies were included (n = 1187 participants, mean age 56.7 [± 7.7] years). In 15 studies, HBPM was conducted within the context of additional high-level tailored support. Overall, the quality of n = 7/18 studies was rated as \"good\"; n = 6/18 were \"fair,\" and n = 5/18 were rated as \"poor.\" Interventions utilizing HBPM had a significant effect on SBP, with 14/16 studies favoring the intervention (88% [95% CI: 62%-98%], P = .002). Favorable effects were also seen on DBP (73% [95% CI: 45%-92%], P = .059). HBPM had a favorable effect on blood pressure goal attainment (86% [95% CI: 42%-100%], P = .062). HBPM in patients with CKD as part of a multicomponent intervention may lead to clinically significant reductions in blood pressure; however, research is needed to support the validity of this claim due to the high heterogeneity across the studies included.
摘要：
高血压是慢性肾脏病(CKD)心血管疾病和疾病进展的重要危险因素。关于家庭血压监测（HBPM）效果的证据有限。本文旨在确定HBPM对CKD患者收缩压（SBP）和舒张压（DBP）的影响。我们在医学文献数据库中搜索了符合条件的研究，这些研究提供了利用HBPM进行干预的前后数据。使用NHLBI质量评估工具评估研究质量。异质性禁止进行荟萃分析，因此根据符号检验计算了效果的估计值，以检查观察到给定的正效应方向模式的可能性。纳入18项研究(n=1187名参与者，平均年龄56.7[±7.7]岁)。在15项研究中，HBPM是在额外的高级别定制支持的背景下进行的。总的来说,n=7/18研究的质量被评为“良好”；n=6/18为“一般”，\"和n=5/18被评为\"差。“利用HBPM进行干预对SBP有显著影响，有14/16项研究支持干预(88%[95%CI：62%-98%]，P=.002）。DBP也有良好的效果(73%[95%CI:45%-92%]，P=.059）。HBPM对血压目标的实现有良好的影响（86%[95%CI：42%-100%]，P=.062）。作为多组分干预的一部分，CKD患者的HBPM可能会导致临床上血压的显着降低；然而，由于纳入研究的异质性较高,因此需要研究来支持这一说法的有效性.
