Strict blood pressure control reduces the risk of adverse outcomes in chronic kidney disease but is difficult to achieve. To inform the design of an educational intervention for patients with chronic kidney disease and hypertension, we used focus groups to identify key patient issues, from both patient and healthcare professional perspectives. Framework methodology was used to analyse data and patient confusion emerged as the core concept. This was both an effect and, in some cases, a cause of the six key themes identified: lack of basic knowledge; conflicting advice; nature of diagnosis; changes in evidence-based practice; views on patient empowerment and views on the patient-health professional relationship. Educational needs identified involved addressing confusion by increasing both knowledge and motivation. In people with chronic kidney disease, confusion can lead to a lack of motivation and negative views that need to be addressed through appropriate education and support.