White coat hypertension was common, and ABPM indicated that non-dipping and reverse dipping of nocturnal BP were particularly predictive of cardiovascular and renal outcomes. Future trials are needed to assess the best means of measuring BP in CKD patients by randomizing patients to ABPM, home BP or office BP directed therapy and to address whether evening dosing to encourage dipping is advanta- geous as recently demonstrated in non-CKD hypertensive Given the technical and economic barriers to routine measurement of ambulatory BP, self-BP recording using automated BP devices has been introduced because these give readings that are more in line than with ABPM than those achieved by office BP measurements.12,402,403 Self-BP measurement and ABPM are being used increas- ingly in BP management and the devices for measuring them usually rely on oscillometric assessment of BP at the elbow. Atrial fibrillation and very high pulse pressures can lead to inaccuracies and hence, re-calibration against traditional methods of BP measurement is important.402 While it is unlikely that self-BP monitoring or ABPM will become part of mainstream CKD montoring in developing countries in the near future, they are likely to become more widely used if further research indicates the value of these techniques in CKD management. Measurement of pulse pressure and pulse wave velocity. The stiffening of arterial walls that accompanies CKD (as well as aging and chronic high BP) causes a loss of the volume compliance in the large arteries such as the aorta, reducing their ability to effectively buffer the systolic pressure wave generated by the left ventricle and thus resulting in higher systolic BP. In diastole, the loss of elastic recoil leads to a reduced diastolic pressure. 