New research from the Systolic Blood Pressure Intervention Trial (SPRINT) shows that nearly all adults with chronic kidney disease (CKD) can benefit from keeping their systolic blood pressure below 120 mm Hg, compared to the older goal of below 140 mm Hg.
The study was presented at ASN Kidney Week 2025, held from November 5–9.
The analysis looked at data from 2,012 people with CKD. Researchers used a method called benefit-harm trade-off analysis to see if the benefits of lower blood pressure outweighed the possible downsides.
These benefits included fewer deaths, fewer heart problems, and less risk of cognitive decline. Possible harms included side effects like fainting or emergency hospital visits due to acute kidney injury.
When researchers modeled the situation for people who place high value on avoiding serious health issues like death and heart attacks, 100% of patients saw a positive net benefit from lowering their blood pressure below 120 mm Hg.
Even when they balanced the benefits and harms as equally important, 9 out of 10 people still had more benefits than risks.
People with more advanced kidney disease—those with an estimated glomerular filtration rate (eGFR) of 20–44 ml/min/1.73 m²—did experience more treatment-related side effects. However, they also saw greater health benefits, resulting in an even higher net benefit compared to people with earlier-stage CKD (eGFR of 45–59 ml/min/1.73 m²).
These findings support current KDIGO Guidelines, which recommend a systolic blood pressure goal of under 120 mm Hg for adults with both high blood pressure and CKD.
The results could encourage patients and doctors to take more action to lower blood pressure in CKD patients, helping to overcome what researchers call “therapeutic inertia”—a common hesitation to make treatment changes.
“This study demonstrates that evidence about blood pressure targets from SPRINT can be personalized to adults with hypertension and CKD by using each individual’s estimated risks and preferences for multiple outcomes related to blood pressure lowering, which could help facilitate shared decision-making conversations,” said Alan Vera, a medical student at the University of California Davis and the study’s lead author.
The research adds strong support for a more personalized approach to blood pressure management in people with CKD. It emphasizes that, for most, aiming for a lower blood pressure can help improve long-term health and reduce the risk of serious complications.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
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