Background: Hypertension remains one of the leading causes of chronic kidney disease (CKD) and contributes to its progression. This study investigates the role of hypertension in CKD development and management, with an emphasis on risk reduction strategies, pharmacological interventions, and lifestyle changes. Data were collected from a cohort of 200 patients over a study duration from January 2024 to June 2024 at the Nephrology Division of Khyber Teaching Hospital (KTH) Peshawar. Aim: To assess the impact of hypertension management on the progression of CKD and evaluate the effectiveness of various treatment strategies in improving patient outcomes. Methods: A cohort study was conducted involving 200 patients diagnosed with hypertension and varying stages of CKD. The study tracked their blood pressure, kidney function, and adherence to treatment protocols over six months. Treatment strategies included the use of antihypertensive medications (ACE inhibitors, ARBs, diuretics, calcium channel blockers), dietary modifications (low-sodium diet), physical activity, and weight management. Clinical outcomes were measured through systolic and diastolic blood pressure levels, estimated glomerular filtration rate (eGFR), and urinary albumin excretion. Results: Significant reductions in blood pressure and improvements in kidney function were observed in the intervention group. Moreover, patients who adhered to combined treatment regimens exhibited a greater improvement in renal outcomes compared to those relying solely on pharmacological interventions. Conclusion: Effective hypertension management is crucial in CKD patients. A combination of pharmacological and non-pharmacological treatments significantly mitigates the progression of CKD and improves overall health outcomes.