Patients and families in areas where ABPM is unavailable or less affordable will be less inclined to follow this recom- mendation and may choose to use clinic-based auscultatory BP monitoring instead. Consideration for implementation. There are no data that suggest differences in bene cial effects of BP lowering be- tween males and females, or children of different ethnic backgrounds or races. However, compared to nonproteinuric kidney diseases, children with proteinuria may derive more clinical bene ts from intensive BP lowering.142 Implementation of ABPM for monitoring treatment of hypertension is challenging.368 Some children have dif culty wearing the monitors and completing the full 24 hours of measurements. Monitors are not always available when needed; they require time from a parent or other adult to return the monitor to the clinic and are expensive. With this in mind, there are certain situations in which there is a low probability of nding elevated BP by ABPM. For example, individuals with clinic BP at #25th percentile are unlikely to have elevated ABPM. Individual practitioners may, therefore, consider less-frequent ABPM monitoring if this level of clinic BP is achieved.360 There are additional challenges on how these guidelines apply to children who are too young to undergo ABPM or to children <120 centimeters in height, for whom no normative ABPM data exist. Additionally, for those on ACEi or ARB, it is important for families to understand how to monitor their children to prevent complications, such as dehydration, hy- potension, and AKI. Rationale The Work Group considered the balance between bene ts and harms, evidence quality, values and preferences, as well as resource utilization in making this recommendation. 