we concentrate on issues relating to BP control in CKD patients that have arisen since 2004. Additional information that may be of help to the clinician (although not specifically relevant to CKD patients) can be found in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) (http://www.nhlbi.nih.gov/guidelines/hypertension/ GENERAL STRATEGIES It is generally accepted that a stepwise combination of lifestyle modifications and drug therapy should be used to lower BP in CKD patients, with escalation of efforts depending on factors such as the severity of the BP elevation, the co-morbidities present and the age of the patient. 2.1: Individualize BP targets and agents according to age, co-existent cardiovascular disease and other co- morbidities, risk of progression of CKD, presence or absence of retinopathy (in CKD patients with diabetes) and tolerance of treatment. (Not Graded) RATIONALE We recognize that individual decision making is required regarding BP targets and agents with the risks and benefit being taken into consideration; however, since there is little evidence from RCTs to guide these decisions, this recom- mendation has not been graded. The potential benefits of lower BP include a decreased risk of both CVD and progression of CKD. To assess the likely benefit in a given patient, the clinician needs to consider such issues as the prior rate of CKD progression, the expected course of the specific disease, the level of urinary albumin excretion and the presence or absence of other risks of CVD. Potential adverse effects generic to treatment used to lower BP include decreases in cerebral perfusion (contributing to dizziness, confusion and falls) and acute deterioration in kidney function. 