Timing of Antihypertensive Medications on Key Outcomes in Hemodialysis

Exclusion Criteria

• •1. Initiation of hemodialysis within previous 90 days
• •2. Inability to provide informed consent
• •3. Currently participating in another clinical trial (intervention study)
• •4. \>2 unexcused missed dialysis sessions in the previous 30 days
• •5. Documented heart failure with reduced ejection fraction (left ventricular ejection fraction \< 40%)
• •6. Cardiovascular event (e.g. myocardial infarction, stroke, heart failure) or procedure (e.g., coronary artery bypass, peripheral arterial bypass grafting, carotid artery procedures, aortic procedures) or hospitalization for unstable angina within the previous 90 days
• •7. End-stage liver disease
• •8. Planned kidney transplant within the next 90 days
• •9. Planned dialysis modality switch (to home hemodialysis, peritoneal dialysis, nocturnal hemodialysis) within the next 90 days
• •10. Pregnancy, currently trying to become pregnant
• •11. Active infection requiring antibiotic, antifungal or antiviral therapies
• •12. Any factors judged by the treatment team to be likely to limit adherence to the interventions
• •1. Active alcohol or substance abuse within the last 12 months
• •2. Plans to move outside of the treatment area within in the next 90 days
• •3. Other medical, psychiatric, or behavioral factors that in the judgement of the study team may interfere with study participation or the ability to follow the intervention protocol