What is the quality of evidence that out-of-office BP measurements provide additional prognostic information in patients with CKD?
There are systematic reviews in the general population showing that high out-of-office BP is associated with CV disease risk independent of office BP. Although there are no systematic reviews in CKD patients, the results from individual studies in CKD are generally consistent with the general population data in that BP differs when measured outside the office versus in the office setting, and out-of-office readings provide additional prognostic information. The systematic reviews and meta-analyses of general population studies provide moderate-quality evidence because of the inherent limitations of observational studies, but the evidence quality is upgraded from low because of the strength of associations of out-of-office BP measurements with critically important outcomes. However, no single outcome trial targeting out-of-office BP has been reported so far in CKD populations.