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.

中文翻译：

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家庭血压监测是否可以改善慢性肾病患者的血压相关结果？系统回顾

高血压是心血管疾病和慢性肾脏病（CKD）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。本综述旨在确定 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检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。研究质量使用 NHLBI 质量评估工具进行评估。异质性阻碍了荟萃分析，因此根据符号检验计算效应估计值，以检查观察给定正效应方向模式的概率。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 是在额外的高级定制支持的背景下进行的。总体而言， n = 7/18 研究的质量 被评为“良好”；n  = 6/18 被评为“一般”，n  = 5/18 被评为“差”。利用 HBPM 进行干预对 SBP 有显着影响，14/16 的研究支持干预（88% [95% CI: 62%–98%]，P  = .002）。 DBP 也有良好的效果 (73% [95% CI: 45%–92%], P  = .059)。 HBPM 对实现血压目标有积极影响（86% [95% CI: 42%–100%]，P  = .062）。作为多成分干预措施的一部分，对 CKD 患者进行 HBPM 可能会导致临床上血压显着降低；然而，由于所纳入的研究存在高度异质性，因此需要研究来支持这一说法的有效性。