Most CKD patients benefit more from strict blood pressure control, lowering heart and brain risks despite higher side effect chances.

A new analysis of the SPRINT trial finds that nearly all adults with chronic kidney disease (CKD) benefit more from a strict systolic blood pressure target of less than 120 mm Hg than the standard less than 140 mm Hg, with 100% showing a net benefit when health gains are prioritized and 90% even when risks like fainting or hospitalization are balanced equally. The study, involving 2,012 CKD patients, showed those with more advanced disease gained greater protection against heart disease, death, and cognitive decline despite higher treatment risks. Results support current guidelines recommending lower blood pressure targets for CKD patients and may help overcome hesitation in treatment intensification. Findings will be presented at ASN Kidney Week 2025.