Objective: Visit-to-visit long term variability of blood pressure (BP) is an important independent risk factor for premature death and cardiovascular events, but relatively little is known about this parameter in patients with chronic kidney disease (CKD). The aim of the study was to clarify the influence of BP long-term variability on the progression of CKD in hypertensive patients. Design and method: 34 patients (16 men and 18 woman) with essential hypertension and CKD included in the study. Mean age was 68,8 ± 13,6 years. 7 pts had impaired glucose tolerance and 9 diabetes mellitus 64% of patients had left ventricular hypertrophy (LVH) by Echocardiography. 34% of patients had carotid atherosclerosis. 10 pts had 2 st of CKD at the beginning of the study, 24 – 3 st CKD. All patients receive antihypertensive treatment: 56% ACE inhibitors, 30% – ARB, 43% - calcium antagonists, 61% - beta-blocker and 30% - diuretics. 86% of patients achieved BP goal. The participants had their office BP measured during the 12-month follow-up We defined systolic and diastolic visit-to-visit variability of BP using three metrics: coefficient of variation, standard deviation of the mean SBP, and average real variability. Results: Glomerular filtration rate correlate significantly with systolic BP variability, but not with BP level. After the 1 year of follow up 6 patients had end-stage renal disease End-stage renal disease in multiple regression analysis was independently associated with systolic BP variability (OR 1,84 CI 95%[1,22–2,46], p = 0,031) and patients age (OR 2,89CI 95%[1,47–10,71], p = 0,034). Left ventricular mass index also significantly correlate with systolic BP variability (r = 0,456; p = 0,050) The correlation was more significant in patients with diabetes mellitus (r = 0,635; p = 0,036). Multiple regression analysis indicated that only mean visit-to-visit systolic BP remained independently associated with LVH after adjustment for age, sex, hypertension, diabetes mellitus, and glomerular filtration rate (p = 0.047). In patients with carotid atherosclerosis diastolic BP variability was higher, then in patients without it (p = 0,05). Conclusions: Thus, the variability of blood pressure may be more significant determinant of CKD progression and development of LVH in patients with hypertension than the achieved BP level.