What are the effects of intensive SBP lowering with target <120 mm Hg on progression to kidney failure in patients with CKD?
No reliable conclusions can be reached on the effects of an SBP target <120 mm Hg on progression to kidney failure in patients with CKD from ACCORD or SPRINT. Previous guidelines, including the KDIGO 2012 BP guideline, recommended more aggressive BP lowering for patients with albuminuria than for those without albuminuria. However, 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.