Nevertheless, a U-shaped relationship between BP, cardiovascular events, and renal function was present. In patients with CKD stage III and IV, a BP less than 140/90 mm Hg appeared to be a reasonable target.
The recommended office BP targets for people with CKD are <140–130 mmHg SBP (lower SBP is acceptable if tolerated) and <80 mmHg DBP.
In Stage 3 CKD, your kidneys have mild to moderate damage, and they are less able to filter waste and fluid out of your blood. This waste can build up in your body and begin to harm other areas, such as to cause high blood pressure, anemia and problems with your bones.
Stage 3 CKD means you have an eGFR between 30 and 59 and mild to moderate damage to your kidneys.
2. Criteria for hypertension among elderly CKD patients
In the 2021 KDIGO guidelines, a target blood systolic pressure of less than 120 mmHg was recommended for the urine albumin-creatinine ratio exceeded 30 mg (A3) for all CKD patients not on dialysis1,2).
More recently, another RCT, the SPRINT (Systolic Blood Pressure Intervention Trial), showed benefits for a lower BP goal of SBP <120 mm Hg in patients aged over 75 years,98 albeit after excluding patients with loss of autonomy, cognitive disorders, diabetes mellitus, and history of stroke.
A lower therapeutic target of SBP 130-139 and DBP 70-79 mmHg can also be considered in 'elderly' (those ≥65 years, but not >80 years) patients. Pharmacologic therapy may also be considered in fit individuals >80 years with an initial SBP ≥160 mmHg and/or DBP ≥90 mmHg while targeting a BP of 130-139/70-79 mmHg.
For a 60-year-old man, stage 1 kidney disease life expectancy will be approximately 15 years. That figure falls to 13 years, 8 years, and 6 years in the second, third, and fourth stages of kidney disease respectively.
As mentioned before, stage 3 kidney disease can be managed efficiently when diagnosed early. Although it may be different for every patient since their lifestyle factors play an important role, the average life expectancy for people diagnosed at 40 is 28 years for women and 24 for men.
Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate.
The more impactful symptoms of kidney disease stage 3 are the health implications of your decreased kidney functioning such as high blood pressure, anemia, and bone disease.
A stage 3 kidney disease diagnosis doesn't necessarily mean that your condition will progress to stage 4 or stage 5. With lifestyle changes and a treatment plan from your doctor, it's possible to slow the progression of CKD and preserve kidney function.
If you have kidney disease, avoid foods and beverages that are high in sodium link. Additional steps you can take to meet your blood pressure goals may include eating heart-healthy and low-sodium meals, quitting smoking, being active, getting enough sleep, and taking your medicines as prescribed.
A GFR of 60 or higher is in the normal range. A GFR below 60 may mean kidney disease. A GFR of 15 or lower may mean kidney failure.
The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be. Protect your kidneys by keeping your blood pressure under control. Medicines that lower blood pressure can also help slow kidney damage.
Eat a kidney-friendly diet and exercise regularly.
Following a kidney-friendly diet may help you slow the progression of kidney disease, especially one that is recommended specifically for you by a dietitian. A dietitian can help you plan meals that you like based on your preferences.
While it's not possible to reverse kidney damage, you can take steps to slow it down. Taking prescribed medicine, being physically active, and eating well will help. You'll also feel better and improve your overall well-being.
Being diagnosed with CKD at an older age is associated with a more near-normal life expectancy. A male diagnosed at the age of 65 in stage 3, for instance, could expect to reach average life expectancy of 76 years old.
You may be able to improve your GFR somewhat by changing your lifestyle. Keep in mind that there's no cure for CKD. But healthy habits may slow the progression of the disease. Because diabetes and high blood pressure are the main causes of CKD, it's vital to keep both under control.
The previous guidelines set the threshold at 140/90 mm Hg for people younger than age 65 and 150/80 mm Hg for those ages 65 and older. This means 70% to 79% of men ages 55 and older are now classified as having hypertension. That includes many men whose blood pressure had previously been considered healthy.
Normal pressure is 120/80 or lower. Your blood pressure is considered high (stage 1) if it reads 130/80. Stage 2 high blood pressure is 140/90 or higher. If you get a blood pressure reading of 180/110 or higher more than once, seek medical treatment right away.
A higher target BP for adults aged 60 or older.
The recommended goal BP is now less than 150/90, instead of less than 140/90 (which was the target recommended in prior guidelines, published in 2003).