Surveys of BP control in CKD patients indicate that three or more agents are frequently needed. With the exception of ARBs or ACE-Is in CKD patients with high levels of urinary albumin or protein excretion, there is no strong evidence to support the preferential use of any particular agent(s) in controlling BP in CKD; nor are there data to guide the clinician in the choice of second- and third-line medications. Since the 2004 KDOQI was published, there has been an increasing trend towards tailoring antihypertensive therapy to the individual patient, taking into account issues such as the presence or absence of high urine albumin excretion, co-morbidities, concomitant medications, adverse effects, and availability of the agents. Ultimately, the choice of agents is less important than the actual reduction in BP achieved, since BP reduction is the major measurable outcome in the individual patient. Other information of value in deciding on the optimal BP lowering regimen include data on drug half-life and dose adjustments in CKD stage 5D, which may be of help in guiding the use of BP lowering drugs in advanced CKD ND.4,76 The optimal timing of administration of medication has not been studied in CKD patients. 