Shlipak MG, et al. - In this nested case–control study within SPRINT (Systolic Blood Pressure Intervention Trial), researchers compared changes in kidney damage biomarkers between incident chronic kidney disease (CKD) case participants and matched control participants as well as between case participants in the intensive (<120 mm Hg) vs the standard (<140 mm Hg) systolic blood pressure (SBP) management groups of SPRINT. Study participants were adults with hypertension without baseline kidney disease. Findings suggested a significant association of higher concentrations of urinary albumin, kidney injury molecule-1, and monocyte chemoattractant protein-1 at baseline with greater odds of incident CKD. Incident CKD in the setting of intensive SBP reduction was accompanied by decreases in levels of kidney damage biomarkers rather than elevations and can, therefore, reflect benign changes in renal blood flow instead of intrinsic injury.