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Estimating central blood pressure in the extreme vascular phenotype of advanced kidney disease. Carlsen et al. demonstrated that the estimation of central blood pressure from peripheral tonometry does not work properly in patients with chronic kidney disease. We explore here the implications of this finding, first by considering the technical conditions for validating central BP monitors, then by discussing the possible causes for discrepancies between chronic kidney disease patients and usual study populations. Lastly, we review the merits and limits of the work by Carlsen et al.