In CKD, what are the typical targets for A1c and blood pressure?

• A. A1c <7; BP <140/90; if proteinuria, BP <130/80
• B. A1c <8; BP <150/90
• C. A1c <7.5; BP <160/100
• D. A1c <6.5; BP <120/80

Answer: (A)

In CKD with diabetes, targets are set to balance reducing complications with safety. The reasonable goal is to keep the A1c around or below 7% for most adults, since tighter glycemic control lowers microvascular risk without excessive hypoglycemia in the CKD population. For blood pressure, aiming for under 140/90 mmHg is standard, as this level reduces cardiovascular risk and slows kidney damage. If there is notable protein in the urine (proteinuria), pushing the BP target further toward or below 130/80 mmHg provides additional kidney protection by reducing intraglomerular pressure and protein leakage.

The other options are less appropriate because they either loosen the glycemic or BP targets too much, or push them too tightly. For example, a less stringent BP goal like 150/90 or 160/100 misses opportunities to protect the kidneys and heart in CKD with diabetes. A1c targets that are less strict than 7% miss the benefit of reducing microvascular complications, while overly aggressive targets (like A1c well below 6.5% with very tight BP of 120/80) increase risk of hypoglycemia and adverse effects in many CKD patients.