Gradually, these advances are being implemented in research and BP management in CKD patients. Ambulatory BP monitoring and self-monitoring at home. There is a long history of assessing BP by means other than the BP measurement taken at an office visit. The gold standard is automated ABPM, the techniques for which have been well described,10,143,401 and self-monitoring using automated devices, which is increasingly used. Recommen- dations and guidelines for the use of ABPM and self- monitoring are accumulating in the hypertension literature (Table 4). There have been a limited number of studies conducted in CKD patients but data suggest that in CKD, high ABPM systolic pressures, and nocturnal non-dipping (i.e., the absence of a drop in BP during sleep) are associated with increased risks of mortality (as in other populations) and of decline in GFR or kidney failure.11,77,78 As has been found for non-CKD patients, office BP measurements are commonly overestimates (in the case of white-coat hypertension) or underestimates (in the case of masked hypertension) of usual BP when compared with ambulatory BP assessments. A recent paper highlights the interest in ABPM in CKD.79 436 hypertensive CKD patients were prospectively followed using ABPM and this was shown to be much more accurate in predicting both renal and cardiovascular outcomes than office BP. 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. 