Algorithm for Diagnosis and Management of Resistant Hypertension in CKD Pseudoresistant Hypertension - Reduce barriers to adherence: • Prescribe generics • Use once-daily medications • Combination formulations • Patient education • Assess for adverse effects Initiate Lifestyle Modifications • Low sodium diet mg/d) • Address obesity • Increase physical activity • DASH diet and reduce alcohol intake • Evaluate for and treat OSA • Discontinue BP-raising medications Resistant Hypertension 1. Evaluate for CKD 2. Screen for primary aldosteronism 3. Consider other causes of 2° HTN eGFR < 30 mL/min/1.73 m2: 1. Add loop diuretic to existing thiazide 2. Titrate to "dry weight" 3. Hold if under dry weight →Add mineralocorticoid antagonist →Refer to HTN specialist #Resistant #Hypertension #CKD #Algorithm #Diagnosis #Management
