Individuals with CKD generally have higher9 BP levels than people with normal kidney function and their BP may be particularly sensitive to some factors related to lifestyle. For example, high salt intake may potentially have a greater impact on BP in patients with CKD than in those without CKD since CKD may reduce the ability to excrete the salt load in the urine. CKD patients may also be more sensitive to harms related to lifestyle interventions; for instance, an individual with tubular disease with salt wasting from the kidney could be at increased risk of hypovolemia if salt intake is restricted. Furthermore, some potential lifestyle interventions, such as increased physical exercise, may be difficult for patients with CKD owing to reduced energy levels. Lifestyle modification offers the potential to lower BP in a simple, inexpensive, effective fashion while also improving a range of other outcomes (e.g., changes in lipid levels resulting from diet and exercise and liver function through moderation of alcohol intake). Because lifestyle changes are applicable to the general population and are potentially implementable at low expense worldwide, the Work Group felt many were sufficiently important to warrant an evidence grade of level 1, with the strength of the evidence varying in accordance to their potential to do harm in CKD patients. 2.3: Encourage lifestyle modification in patients with CKD to lower BP and improve long-term cardio- vascular and other outcomes: 2.3.1: We recommend achieving or maintaining a RATIONALE K Weight reduction lowers BP in the general population. K Observational studies show that weight-loss strategies reduce BP in CKD patients. K Weight-reduction strategies may result in other health benefits to CKD patients including reduction in urine albumin or protein levels, improved lipid profile and increased insulin sensitivity. 