The KDIGO 2012 guideline reversed previous recom- mendations from other organizations that called for more- aggressive BP-lowering therapies among CKD patients with diabetes, largely because ACCORD-BP failed to demonstrate statistically signi cant bene ts for the primary CV endpoint in the intensive BP-lowering arm. Since then, SPRINT and further analyses of ACCORD, together with combined ana- lyses of these 2 trials, have supported the conclusion that intensive BP-lowering therapy might well confer similar bene ts among patients with diabetes and CKD as in patients with CKD alone. However, the quality of evidence for BP target among CKD patients with concomitant diabetes is low, especially among those with advanced CKD. The recommendation of SBP <120 mm Hg is classi ed as weak (in the dichotomous classi cation of strong and weak in GRADE), raising concerns that clinicians and patients may decide to ignore the guidance and opt for less-intensive treatment. The Work Group debated whether to provide a strong recommendation for an SBP target of at least <140 mm Hg for all patients with CKD, together with separate recommendations for lower SBP (<120 mm Hg) targets in speci ed subgroups. This more complex alternative was eventually rejected, on the basis that it would probably persuade clinicians to continue to adopt an SBP target of <140 mm Hg for all CKD patients, thus denying many patients the potential advantages of tighter control. A strong recommendation implies that most patients and caregivers would want the recommended course of action, whereas a weak recommendation states that the majority of people would want the recommended course of action, but some would not. Regardless of the strength of recommendations, but especially for weak recommendations, clinicians should understand the nature and rationale of the recommendations and engage in shared decision-making with the patients, as discussed above. 