CIRCULATION AND HEMODYNAMICS: Edited by Matthew R. Weir and Roland C. BlantzBlood pressure parameters and morbid and mortal outcomes in nondialysis-dependent chronic kidney diseaseWalther, Carl P.a; Chandra, Aravindb; Navaneethan, Sankar D.a,cAuthor Information aSelzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine bDepartment of Medicine, Baylor College of Medicine cSection of Nephrology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA Correspondence to Sankar D. Navaneethan, MD, MS, MPH, Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030, USA. E-mail: Sankar.Navaneethan@bcm.edu Current Opinion in Nephrology and Hypertension: January 2018 - Volume 27 - Issue 1 - p 16-22 doi: 10.1097/MNH.0000000000000375 Buy Metrics Abstract Purpose of review Observational and interventional studies provide conflicting evidence regarding optimal blood pressure (BP) control in persons with chronic kidney disease (CKD). Recent publications provide additional information to inform therapeutic decision-making. Recent findings Targeting SBP to less than 120 mmHg, versus less than 140 mmHg, decreased cardiovascular events and all-cause mortality in persons with nondiabetic CKD. A meta-analysis of trials testing blood pressure management among nondialysis-dependent CKD patients (15 924 total patients) found more intensive therapies generally reduced mortality in all subgroups. Observational studies demonstrate that low SBP is associated with higher mortality in CKD. A recent report suggests that this is because of death from cardiovascular and noncardiovascular and nonmalignant causes, whereas higher BP is associated with death from cardiovascular causes. The shape of association between BP and cardiovascular and noncardiovascular events also appears to vary depending on baseline risk factors. Furthermore, BP measurement methodology may differ importantly between observational and interventional studies. Summary We review and summarize observational and interventional literature relating BP parameters to key clinical outcomes in persons with CKD. Apart from the inherent differences between these study designs, the disparate findings from trials and observational studies may be because of differences in patient characteristics and BP measurement techniques. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.