Resistant hypertension/CKD referral checklist

Urgency tier

• Immediate emergency assessment for suspected acute hypertensive organ injury; do not wait to collect routine BP logs or referral investigations.
• Rapidly worsening kidney function requires urgent assessment according to clinical severity and electrolyte findings.
• Expedited referral for persistent uncontrolled BP despite guideline-based multi-drug therapy.
• Routine referral for complex optimization when BP remains above target despite structured management.

Minimum pre-referral workup

• Provide serial office and home blood pressure logs with measurement technique notes.
• Include medication list, adherence review, and dose titration timeline.
• Attach renal function trend, electrolytes, urine ACR, and key comorbidity profile.

Referral packet checklist

• BP trend summary and current treatment regimen.
• Objective renal and metabolic data with dates.
• Specific clinical question for nephrology/internal medicine/cardiology.

Pre-referral optimization tasks

• Confirm adherence barriers and simplify regimen where feasible.
• Remove avoidable nephrotoxic exposures.
• Reinforce home BP protocol and clear return precautions.

References

• Hypertension Canada Guidelines (opens in a new tab)
• KDIGO Blood pressure in CKD (opens in a new tab)

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