chapter 2 www.kidney-international.org Chapter 3: Blood pressure management in patients with CKD, with or without diabetes, not receiving dialysis 3.1 Blood pressure targets Recommendation 3.1.1: We suggest that adults with high BP and CKD be treated with a target systolic blood pressure (SBP) of <120 mm Hg, when toler- ated, using standardized of ce BP measurement (2B). The recommendation is based on a single high-quality RCTwith important bene ts in the study cohort that included a sub- stantial number of CKD patients, even though the recommen- dation is considered weak by GRADE standards. This recommendation assumes that standardized of ce BP measure- ment has been taken according to Recommendation 1.1. The recommendation suggests that the majority of people would want the recommended course of action, but some, particularly in the subgroups mentioned below, may not, because adjusting BP-lowering therapy to achieve this target SBP causes potential bene ts and harms that may vary with comorbidities, severity of CKD, existing treatment burden, and the presence of white- coat or masked hypertension. The statement is weak because it is based primarily on a subgroup from 1 RCT; however, the subgroup was prespeci ed from a very high-quality trial. This recommendation does not apply to patients with CKD who have a kidney transplant; this guideline does not apply to those receiving dialysis. Key information Balance of bene ts and harms. There is evidence that tar- geting SBP to <120 mm Hg, when measured under stan- dardized conditions, reduces CV events and all-cause mortality in CKD (Supplementary Table S1191 93 ). In most people with high BP, including the frail and elderly, these bene ts appear to outweigh the risks of harm (e.g., hypotension and acute kidney injury [AKI]). 