Battle of the giants: KDIGO vs. Cochrane - who is the winner in the fight for blood pressure targets in chronic kidney disease?

Hypertension (HTN) in chronic kidney disease (CKD) is often regarded as the main villain. It represents the leading cause of dialysis-dependent CKD in Brazil and the second most common worldwide, yet it is also a frequent consequence of renal disorders that induce secondary HTN. In other words, HTN in CKD is a double-edged sword-causing disease progression when primary and aggravating existing injury when secondary, through multiple pathophysiological mechanisms. The most frequently cited blood pressure targets for CKD management in the current scientific literature come from two major authorities in evidence-based recommendations: the 2024 KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guidelines and the 2024 Cochrane Library systematic review and meta-analysis. This article aims to examine and compare the blood pressure targets proposed for CKD by these two leading institutions.