OBJECTIVES: Advanced stage chronic kidney disease (CKD) (stages III-V) elevates the risk of cardiovascular mortality by 15%. Use of antihypertensives is therefore critical. This study estimates (1) the prevalence of advanced stage CKD in a representative sample of the US population, and (2) patterns of antihypertensive drug use in advanced stage CKD. METHODS: A retrospective cross-sectional analysis of 2009-2010 data from the National Health and Nutrition Examination Survey (NHANES) was conducted.  We calculated estimated glomerular filtration rate (eGFR )  to classify participants as stage-III (Moderate - eGFR 30-59 mL/min/1.73m2), stage-IV (Severe - eGFR 15-29 mL/min/1.73m2), or stage-V (Renal Failure -eGFR  < 15 mL/min/1.73m2 ). Pregnant women and patients <18 years of age were excluded. Survey weights were applied to obtain national estimates. RESULTS: The estimated 2009-2010 prevalence of advanced stage CKD was 5.7%, representing 11,535,528 US adults.  Of these, an estimated 10,344,775 were stage-III (89.7%), 847,848 were stage-IV (7.4%), and 342,905 were stage-V (3.0%). The prevalence of advanced stage CKD was higher in females and white patients with a median age of 76 years.  Among the advanced stage CKD population, 82.8% used antihypertensives.  Monotherapy accounted for 24.8% of this use, while 75.2% were on combination therapy. The most commonly used monotherapies were angiotensin converting enzyme inhibitors (ACE-I) (28.2%), beta blockers (27.5%), and diuretics (20.7%). For those on combination therapy, use of two diuretics (28.3%) was most common, followed by combinations of diuretic plus a beta-blocker (26.0%) and diuretic plus an ACE-I (23.8%). CONCLUSIONS: The estimated prevalence of advanced stage CKD is nearly 6% among US adults, with most being moderate severity. Most of these CKD patients used an antihypertensive, and the majority used two or more agents.  Further studies are required to evaluate appropriateness of antihypertensive agent and associated cardio-protective effects.