Patients with microalbuminuria are at high risk for progres- sion of CKD as well as development of CVD.18,153,162165 RCT data suggest that BP control is particularly important in CKD patients with high urine albumin levels. Short-term follow-up data from the MDRD study142 showed an interaction of BP target with level of urine protein, with a definitive benefit for kidney outcomes in patients with 41 g of urine protein per 24 hours and GFR (in MDRD Study A), with a trend toward a benefit with lower protein levels. Long-term follow-up showed a benefit of a low target BP and no interaction with the urine protein level, suggesting that the benefit may extend to all protein levels. In subgroup analyses, the benefit was statistically significant in those with urine protein excretion of 40.3 g per 24 hours166 (H Tighiouart, personal communication). However, there may have been insufficient statistical power to detect the interaction; hence, the risk reduction may have been greater in those with higher urine protein levels. Long-term follow- up data from the MDRD study also showed a benefit with regard to kidney outcomes with a lower target BP in specific groups, such as patients with polycystic kidney disease and non-glomerular diseases, that frequently have low urine albumin levels. Long-term follow-up in the AASK study demonstrated a benefit of lower target BPs in patients with It is unclear whether this PCR cutoff can be translated into an albumin-level cutoff, as this conversion is likely to be dependent on the type of kidney disease, and the ratio of glomerular albuminuria to tubular proteinuria. 