Intensive Blood Pressure Control in Autosomal Dominant Polycystic Kidney Disease—How Safe Is It?

To the Editor Maintaining optimal blood pressure in patients without diabetes with chronic kidney disease (CKD) has always been controversial. In a systematic review and meta-analysis published in a recent issue of JAMA Internal Medicine, Tsai et al¹ assessed the clinical data of 8127 patients; they focused on detecting an association between intensive blood pressure control and renal outcomes in patients without diabetes with CKD. Consequently, no significant difference in major renal outcomes was found between intensive (<130/80 mm Hg) and standard BP control (<140/90 mm Hg) groups during a median follow-up of 3.3 years. Nevertheless, nonblack patients or those with higher levels of proteinuria were found to benefit from the intensive BP-lowering strategy.