What is the recommendation for patients with CKD and albuminuria with regards to BP lowering?
Previous guidelines, including the KDIGO 2012 BP guideline, recommended more aggressive BP lowering for patients with albuminuria than for those without albuminuria.141 These recommendations were based largely on the subgroup findings of the MDRD,97 as described above, and in the pediatric population, the ESCAPE trial (Chapter 5).142 With the adoption of an SBP target <120 mm Hg for all patients with CKD in the present revised guideline based on the evidence for CV and survival benefits, separate targets for patients with and without albuminuria are no longer required. There is no evidence supporting an even lower target (e.g., <110 mm Hg) for patients with severely increased proteinuria.