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Table 1 Blood pressure targets in people with diabetes through stages of kidney function impairment

From: Management of hypertension and renin-angiotensin-aldosterone system blockade in adults with diabetic kidney disease: Association of British Clinical Diabetologists and the Renal Association UK guideline update 2021

 

Stage of kidney function impairment

Normal kidney function, normoalbuminuria

Normal kidney function, microalbuminuria

CKD stages 1–3

CKD stages 4–5 (non-dialysis)

CKD stage 5 (dialysis)

Type 1 diabetes in mmHg (evidence grade)

< 140/80–90 (2D)

< 120/80 (2D)d (for< 30 years)

≤130/80 (1B)

120/80 (2D)d

≤130/80 (1B)

120/80 (2D)d

≤140/90 (1B)

≤130/80 for albuminuric(2C)

≤140/90 (2D)c (interdialytic BP)

Type 2 diabetes in mmHg (evidence grade)

< 140/90 (1D)

< 150/90 (2B)b (for ≥75 years)

< 130/80 (2D)

< 130/80 (2D)

< 140/90 (1B)a

< 130/80 for albuminuric (2C)

< 140/90 (2D)c (interdialytic BP)

  1. CKD chronic kidney disease, BP blood pressure
  2. aFor adults > 65 years a higher target > 140/90 may be appropriate
  3. bFor frail adults > 75 years a higher target > 150/90 may be appropriate to avoid side effects
  4. cMonitor and target inter-dialytic home BP for people on dialysis
  5. d Lower targets for younger adults aged < 30