Treatment of Hypertension in Association with Non-Diabetic Chronic Kidney Disease

1. For patients with non-diabetic chronic kidney disease, target BP is < 140/90 mmHg (Grade B).
2. For patients with hypertension and proteinuric chronic kidney disease (urinary protein > 500 mg/24hr or albumin to creatinine ratio [ACR] > 30 mg/mmol), initial therapy should be an ACE inhibitor (Grade A) or an ARB if there is intolerance to ACE inhibitors (Grade B).
3. Thiazide/thiazide-like diuretics are recommended as additive antihypertensive therapy (Grade D). For patients with chronic kidney disease and volume overload, loop diuretics are an alternative (Grade D).
4. In most cases, combination therapy with other antihypertensive agents may be needed to reach target blood pressures (Grade D).
5. The combination of an ACE inhibitor and ARB is not recommended for patients with nonproteinuric chronic kidney disease (Grade B).