For patients with high blood pressure (BP) and CKD who are not receiving dialysis, a systolic BP of less than 120 mm Hg measured by standard- ized technique should be targeted, according to a synopsis of the Kidney Disease: Improving Global Outcomes 2021 clinical practice guideline pub- lished in the Annals of Internal Medicine. The au- thors provided 11 recommendations and 20 prac- tice points for the management of BP in patients with CKD who are not receiving dialysis. They include:

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  • Standardized office BP measurement in pref- erence to routine office BP measurement for management of high BP; standardized office BP refers to measurements obtained according to recommended preparations and measurement techniques.
  • For patients with high BP and CKD not receiv- ing dialysis, sodium intake of less than 2 g/day is recommended.
  • Patients with high BP and CKD are advised to undertake moderate-intensity physical activity for at least 150 minutes/week or to a level compatible with their cardiovascular and physical tolerance.
  • Adults with high BP and CKD should be treated with a target systolic BP of less than 120 mm Hg, when tolerated.
  • Renin-angiotensin system inhibitor (RASI) ther- apy is recommended for those with high BP, CKD, and severely increased albuminuria with- out diabetes and for those with high BP, CKD, and moderately to severely increased albuminuria with diabetes.
  • RASI therapy is suggested for those with high BP, CKD, and moderately increased albuminuria without diabetes.