What is the recommended blood pressure target for CKD patients, and how does this relate to RAAS blockade?

• A. <140/90; RAAS blockade is optional
• B. Target <130/80; RAAS blockade remains foundational but monitor potassium and creatinine
• C. <120/70; RAAS blockade contraindicated
• D. <150/90; RAAS blockade not necessary

Answer: (B)

In CKD, aiming for a lower blood pressure helps protect kidney function and reduce cardiovascular risk. The recommended target is to keep blood pressure below 130/80. A key part of achieving this is using blockade of the renin-angiotensin-aldosterone system—ACE inhibitors or ARBs—because they lower intraglomerular pressure and reduce proteinuria, which slows kidney disease progression and protects the kidneys over time. This approach is foundational in CKD with hypertension, but it requires careful lab monitoring since these drugs can raise potassium levels and, in some cases, alter kidney function. If potassium rises or creatinine increases after starting or adjusting a RAAS blocker, clinicians may modify the dose or consider alternatives while continuing to work toward the blood pressure goal. The other options misstate either the target or the role of RAAS blockade, which is central, not optional or unnecessary.