KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease
KDIGO 2021 makes two moves at once: it lowers the systolic target in CKD to <120 mmHg, and it makes that target conditional on standardised office measurement — the technique used in SPRINT, not the one used in most clinics. Renin–angiotensin-system inhibitors remain first-line in albuminuric CKD, diabetic and non-diabetic alike, while dual RAS blockade is explicitly ruled out. Kidney-transplant recipients get a separate, higher target. The register's trials behind the target and the drug choice are grouped below.
This guideline cites 7 of the 58 landmark trials in our Nephrology register.
Blood-pressure targets in CKD2
- 2017SPRINT-CKDNephrology · CKD · Blood-pressure targetsSystolic Blood Pressure Intervention Trial — chronic kidney disease subgroup
- 2002AASKNephrology · CKD · RAAS blockadeAfrican American Study of Kidney Disease and Hypertension
RAS blockade in diabetic kidney disease3
- 2001RENAALNephrology · CKD · RAAS blockadeReduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan
- 2001IDNTNephrology · CKD · RAAS blockadeIrbesartan Diabetic Nephropathy Trial
- 1993Captopril-DNNephrology · CKD · RAAS blockadeCaptopril in Diabetic Nephropathy (Collaborative Study Group)
RAS blockade in non-diabetic proteinuric CKD1
- 1997REINNephrology · CKD · RAAS blockadeRamipril Efficacy in Nephropathy
Dual RAS blockade — ruled out1
- 2013VA NEPHRON-DNephrology · CKD · RAAS blockadeVeterans Affairs Nephropathy in Diabetes