Not all clinicians agree with the currently recommended BP targets, at least not for all of their patients. The evidence supporting current BP targets in CKD has been challenged, reinforcing However, surveys have shown that less stringent BP targets, such as 160/90 mm Hg, are also not The BP targets recommended in this guideline are higher than those in some previous publications and it remains to be seen whether this will result in a higher proportion of CKD patients achieving them. The trial data are not directly relevant to a real world setting. There are few systematically collected data to support the notion that BP control cannot be achieved in most patients. However several important issues need to be considered when extrapolating from clinical trials to a real world setting. Firstly, patients recruited into RCTs are selected for characteristics that increase the likelihood of BP control. These include a lack of co-morbidities, an absence of previous adverse reactions to the BP-modifying agents used in the trial, good BP control during a run-in or washout period and high motivation, reflected by the patients willingness to enroll. Secondly, patients partici- pating in trials are often micro-managed in specialized clinics, where frequent reinforcement and pill-counting increases the likelihood of adherence to the drug regimen. Thirdly, patients who drop out because of drug-related side effects or non- adherence are usually accounted for in intention-to-treat analyses and the overall proportion of dropouts is not often reported (although may be 10% or more of the recruited population). 