Original Article Blood Pressure and Risk of All-Cause Mortality in Advanced Chronic Kidney Disease and Hemodialysis The Chronic Renal Insufficiency Cohort Study Nisha Bansal, Charles E. McCulloch, Mahboob Rahman, John W. Kusek, Amanda H. Anderson, Dawei Xie, Raymond R. Townsend, Claudia M. Lora, Jackson Wright, Alan S. Go, Akinlolu Ojo, Arnold Alper, Eva Lustigova, Magda Cuevas, Radhakrishna Kallem, Chi-yuan Hsu; the CRIC Study Investigators Abstract—Studies of hemodialysis patients have shown a U-shaped association between systolic blood pressure (SBP) and mortality. These studies have largely relied on dialysis-unit SBP measures and have not evaluated whether this U-shape also exists in advanced chronic kidney disease, before starting hemodialysis. We determined the association between SBP and mortality at advanced chronic kidney disease and again after initiation of hemodialysis. This was a prospective study of Chronic Renal Insufficiency Cohort participants with advanced chronic kidney disease followed through initiation of hemodialysis. We studied the association between SBP and mortality when participants (1) had an estimated glomerular filtration rate