Intensive Blood Pressure Lowering May Protect Against Kidney Failure in CKD

Compared with standard regimens, a more intensive blood pressure-lowering strategy reduced the risk of kidney failure events (defined as either a composite of doubling of serum creatinine level and 50% decline in GFR, or ESRD) by approximately 20% in a recent systematic review of all relevant reports published between 1950 and 2011. Intensive blood pressure lowering reduced the risk of kidney failure by 27%, but not in patients without proteinuria at baseline. The CMAJ review found no clear effect on the risk of cardiovascular events or death.