When combined with a loop diuretic, thiazides are particularly effective in inducing diuresis, but they often lead to hypokalemia and hy- There are no data on clinical outcomes with loop diuretics in the treatment of high BP with or without CKD. The most common side effects of each antihypertensive drug class for patients with CKD include: for both ACEi and ARBs, hyperkalemia as well as AKI, the latter when com- pounded by volume depletion or renal artery stenosis; for diuretics, hypokalemia; for dihydropyridine CCBs, edema; for non-dihydropyridine CCBs, constipation and bradyar- rhythmias when used in conjunction with beta-blockers; cough with ACEi; fatigue and limited exercise tolerance with beta-blockers; somnolence or dry mouth with central alpha- agonists; rebound hypertension if clonidine is stopped suddenly without taper; dizziness with alpha-blockers; hyper- kalemia with MRA; headache with hydralazine; and edema and hirsutism with minoxidil, to name some examples. The SPRINT research algorithm for BP management is presented in Figure 5 with slight modi cations of the foot- notes. Clinicians should use this as a reference and modify it as they see t. More detailed descriptions and recommenda- tions about the use of antihypertensive drugs, various drug combinations, potential advantages, or adverse effects is beyond the scope of this guideline; readers are referred to standard textbooks and guidelines. Recommendation 3.2.1: We recommend starting renin-angiotensin-system inhibitors (RASi) (angio- tensin-converting enzyme inhibitor [ACEi] or angiotensin II receptor blocker [ARB]) for people with high BP, CKD, and severely increased albu- minuria (G1 G4, A3) without diabetes (1B). This recommendation is strong according to GRADE, based on 3 moderate-quality RCTs with important bene ts in CKD pa- tients. The recommendation suggests that the majority of people would want the recommended course of action. 