Background: Achieving target blood pressure is important in retarding the progression of chronic kidney disease (CKD). Optimizing patient’ s hypertension solely based on clinic blood pressure could be harmful as it may be masked by white coat hypertension. Objectives: This study aimed at determining the prevalence of white coat hypertension (WCHT) in patients with CKD and correlating this with their target organ damage evidenced by left ventricular hypertrophy (LVH) and carotid intima media thickness (CIMT). Methods: A cross sectional study of 99 patients with CKD (stage 3 to 5 with eGFR Epi of < 60 mL/min/1. 732) at a CKD clinic was conducted. Demographic data, routine blood investigations, and number of antihypertensive medication were recorded. Mean clinic blood pressure of the last 2 visits were taken followed by 24-hour ambulatory blood pressure monitoring (24-hour ABPM), electrocardiography, and carotid ultrasound measurement. Results: Ninety-nine patients (42 males and 57 females) with median age of 62 (55 to 69) years old and predominantly Malays ethnicity were recruited. The prevalence of WCHT was 34. 3% (34 patients), and 65. 7% (65 patients) had sustained hypertension (SHT). Median eGFRs were comparable in both groups (P = 0. 479). Despite comparable mean clinic blood pressure (P = 0. 85), the WCHT group had significantly lower mean average systolic, daytime, and night time blood pressure when compared with the SHT group (120. 82 8. 24 vs. 153. 20 18. 70), (124. 50 9. 51 vs 155 18. 86), (111. 97 20. 07 vs 146. 22 21. 17 ) and diastolic (66. 36 85. 79 vs. 82. 35  12. 17), (68. 71 10. 94 vs 84. 11. 8), (62. 68 7. 78 vs. 79. 28 12. 17) respectively (P < 0. 05). The trend towards significance of LVH in the WCHT compared with the SHT group (52% vs. 38% (P = 0. 066)) and the SHT group had a significantly higher median CIMT 0. 80mm (0. 70-0. 90) as opposed to the 0. 60mmmedian of the WCHT group (0. 60 to 0. 70) (P < 0. 05). Two-thirds of SHT were non dippers. Conclusions: White coat hypertension is prevalent in CKD. Patients with SHT had significant carotid intima thickening; LVH was detected more commonly in the WCHT group.

Objective: Malnutrition is closely linked to chronic kidney disease (CKD) in adult patients with poor outcome. But data on pediatric patients is inadequate. The aim of this study was to describe the prevalence of growth failure and malnutrition in pediatric CKD patients and explore the relationship of these parameters to each other and to other clinical parameters.Methods: This study included 42 patients and 29 healthy children matched for age and gender. Patients were classified firstly in age group and secondly in therapy modalities. Nutritional evaluations were performed according to the kidney disease Outcomes Quality Initiative guidelines, and we performed adjustments using values from children with the same chronological age as reference.Findings: In pubertal group, the mean height SDS was lower than in pre-pubertal period while it was higher than in early childhood (P=0.4 and P=0.03 respectively). In all groups, 45% of patients had malnutrition: 20 patients on predialysis, 22 patients with end stage renal disease (14 on hemodialysis, and 8 on peritoneal dialysis). The mean weight SDS was lower in end stage renal disease groups (P<0.001). The height SDS was lower in end stage renal disease groups (P<0.001).Conclusion: Growth failure and malnutrition remain a significant clinical problem as age and therapy modalities are dependent in children with CKD.