OBJECTIVES: To investigate the management of hypertension in adult Malaysian population suffering from chronic kidney disease stage (CKD) stage 3-5. METHODS: A retrospective, cross-sectional study was conducted on 300 patients with CKD stage 3 (n = 98), 4 (n = 76) and 5 (n = 126) in CKD Resource Center of Hospital University Science Malaysia, Kelantan, Malaysia. RESULTS: The mean age of all patients was 58.86 ± 13.47 years and there was preponderance of male subjects (69%). The prevalence of hypertension was 91.3%; almost universal among the sufferers of stage 3, 4 and 5 of CKD (87.8%, 94.7% and 92.1%, respectively). In CKD stage 5, mean systolic blood pressure was considerably higher than in stage 4 and 3 (p = 0.009).The percentage of patients with systolic BP < 130 mm Hg and diastolic BP < 80 mm Hg was 30.3% and 49.0%, respectively. Only 24.3% of the total patients had BP < 130/80 mm Hg despite usingmultiple antihypertensive medications. The proportion of patients consuming antihypertensive drugs was as: angiotensin-converting enzyme inhibitors (ACE-Is) (25%), angiotensin receptor blockers (ARBs) (14.3%),combined ACE-Is and ARBs (2.7%), calcium channel blockers (66.3%), β-blockers (40.7%), diuretics (60%) and α-blockers (14.3%). There was significantly lower percentage of patients on ACE-Is and ARBs in stage 5 than in stage 4 and 3 CKD patients. Proteinuria was present in 71.7% of the patients and there was significant difference proteinuria between stage 3, 4 and 5 (55.1 vs 59.2 vs 92.1, p = 0.000). CONCLUSIONS: Underutilization of some classes of anti-hypertensive medications is apparent.Higher percentage of proteinuria in CKD stage 5 patients may be attributed to the underuse of ACE-Is and ARBs in stage 5.The study further indicated the need of employinginstructive efforts to get valuable outcomes of antihypertensive treatment in CKD sufferers.