KEEP Healthy

FiveStudy Shows Blood Pressure of 140/90 and Up Increases Kidney Failure Risk

High blood pressure has always been linked with chronic kidney disease (CKD), but doctors have debated for years what blood pressure levels would slow the disease’s progression toward kidney failure. Recent data from the Kidney Early Evaluation Program (KEEP) indicate that blood pressure targets for those with kidney disease may have been more strict than necessary. These findings could help doctors treat kidney disease patients who are also suffering from high blood pressure.

Researchers studied over 16,000 KEEP participants living with kidney disease (Stages 3 and 4) and found that patients with blood pressure measurements of 150/90 and above were at the greatest risk for developing kidney failure. Kidney failure is also referred to as Stage 5 kidney disease and End Stage Renal Disease (ESRD). This study also found that people with blood pressures of 140/90 were at increased risk for their kidney disease progressing to kidney failure, but not as much as those with measurements of 150/90 or greater.

The current guidelines recommend that individuals with CKD and high blood pressure keep their blood pressures below 130/80, a stricter level than those who have only been diagnosed with high blood pressure. People who have been diagnosed with high blood pressure and who have not been diagnosed with kidney disease are encouraged to keep their blood pressure below 140/90. Blood pressure readings are considered normal if they are below or equal to 120/80.

According to the study’s lead author, Dr. Carmen Peralta, who is also a physician on the KEEP steering committee, “The study highlights the importance of blood pressure control in people with CKD, but it suggests that a target of 140/90 may be strict enough to delay progression to End Stage Renal Disease.” It is difficult for many patients to control their blood pressure below 130/80 even with the use of multiple blood pressure lowering medications because many people have other health conditions in addition to hypertension and chronic kidney disease. Dr. Peralta suggests that based upon these findings “clinician efforts should concentrate on lowering the blood pressure of those extremely out of control, rather than fine-tuning the blood pressure of those already at 140/90.”

The National Kidney Foundation is committed to providing health information and continuing its screening initiatives to target individuals at risk for developing kidney disease through the Kidney Early Evaluation Program (KEEP). Since its inception, the program has screened more than 170,000 Americans. To find a screening near you, visit

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