Table 1:

Characteristics of the studies included in the meta-analysis

Study	Inclusion criteria	BP, mm Hg			Regimen used to achieve target BP	Follow-up, yr	Patient characteristic

		Baseline, systolic/diastolic	Target in intervention group	Target in control group			Total, no.	With CKD, no.	Age, mean, yr	Female sex, %	Diabetes mellitus, %	Kidney failure, no.	Major CV event, no.
Studies that only recruited patients with CKD

AASK (Appel et al.13; Wright et al.26)	African American, hypertension, GFR 20–65 mL/min per 1.73 m² and no other identified causes of renal insufficiency	150.5/95.5	Mean < 92	Mean 102–107	3 × 2 study design; participants were separately and randomly assigned to a class of drugs (ramipril, metoprolol or amlodipine) and separately to the BP target; in the cohort phase, all were switched from randomized therapy to ramipril	8.8–12.2	1 094	1 094	55	38.8	Excluded	422^¶	225

Ruggenenti et al.14	Nondiabetic nephropathy with proteinuria 1–3 g/d and GFR < 45 mL/min per 1.73 m² or proteinuria > 3 g/d and GFR < 70 mL/min per 1.73 m²	136.7/84.1	< 130/80	Diastolic < 90	All patients were given ramipril and received add-on therapy with felodipine as required	1.6	338	338	54	25.7	Excluded	72^‡	9

Klahr et al.17	CKD, serum creatinine 1.4–7.0 mg/dL (male) or 1.2–7.0 mg/dL (female)	130.5/80	Mean < 92	Mean < 107	ACE inhibitors, with or without a diuretic	16.7	840	840	52	40	5.10	616^‡	NR^*

Wühl et al.18	CKD, age 3–18 yr and GFR 15–80 mL/min per 1.73 m² with 24-h mean BP elevated or controlled by antihypertensive agents	118.3/73.0	24-hr mean BP < 50th percentile	24-hr mean BP in the 50th– 95th percentile	All patients were given ramipril and received any other class of antihypertensive agents as required	5.0	385	385	12	41	NR^†	115^§	NR

Toto et al.21	Hypertensive nephrosclerosis, serum creatinine > 1.6 mg/dL or GFR < 70 mL/min per 1.73 m²	123.1/76.5	Diastolic, 65– 80	Diastolic, 85– 95	2 × 2 study design; patients were randomized to either placebo or enalapril and then a stepped-care approach: diuretic; n-blocker; hydralazineor minoxidil; and clonidine, α-methyldopa or R1- blocker	3.4	77	77	56	37.7	Excluded	19^†	NR

Schrier et al.28	Autosomal-dominant polycystic kidney disease with hypertension and left ventricular hypertrophy; age 20–60 yr; creatinine clearance > 30 mL/min;	142.5/94.5	< 120/80	< 135–140/85–90	Patients were randomized to either enalapril- or amlodipine-based approaches	7.0	75	75	41	45	NR	8^‡	NR

Studies reporting subgroup data for patients with CKD

UK Prospective Diabetes Study Group22^*	Newly diagnosed type 2 diabetes mellitus with hypertension	159.3/94	< 150/85	< 180/105	Captopril or atenolol	8.4	1 148	103	56	44.5	100	NR^*	NR^*

Hansson et al.23^*	Hypertension, diastolic BP 100–115 mm Hg	169.7/105.4	Diastolic < 80	Diastolic < 85 or < 90	All initially received felodipine and add-on therapy with ACE inhibitors or β-blockers and then a diuretic	3.8	1 8790	3 619	62	47	8	NR^*	186

Estacio et al.24^*	Type 2 diabetes mellitus with diastolic BP ≥ 90 mm Hg	155/98	Diastolic < 75	Diastolic 80–89	Patients were randomized to either enalapril or amlodipine initially, and received add-on with metoprolol and hydrochlorothiazide	5.0	470	120	58	32.6	100	NR^*	29

Schrier et al.25^*	Type 2 diabetes mellitus with normotension (diastolic BP 80– 89 mm Hg)	136.4/84.4	Reduction in diastolic BP of 10 mm Hg from baseline	Diastolic 80–89	In the intensive group, patients were randomized to either tonisoldipine or enalapril	5.3	480	137	59	45.5	100	NR^*	23

Hayashi et al.27^*	Older adults (65–85 yr), hypertension and systolic BP > 160 mm Hg	163/89.6	Systolic < 140	Systolic < 160	All patients received efonidipine and other agents were added as needed	2.0	4 418	2 499	74	64	11.9	13^¶	NR

Note: ACE = angiotensin-converting enzyme, BP = blood pressure, CKD = chronic kidney disease, CV = cardiovascular, GFR = glomerular filtration rate, NR = not reported.
↵* CKD was determined by estimated GFR < 60 mL/min per 1.73 m².
↵† Kidney failure defined as either a composite of 50% decline in GFR, 100% increase in serum creatinine or end-stage kidney disease.
↵‡ Kidney failure defined as end-stage kidney disease.
↵§ Kidney failure defined as a composite of 50% decline in GFR or end-stage kidney disease.
↵¶ Kidney failure defined as a composite of 100% increase in serum creatinine or end-stage kidney disease.