Inclusion Criteria:  Over 18 years of age; eGFR <30 mL/min/1.73m2 as determined by the CKD-EPI equation (within 30 days of screening); Office brachial cuff systolic blood pressure between 120 and 160 mmHg (using automated office blood pressure).  Exclusion Criteria:  Already taking 5 or more anti-hypertensive medications (any class) Unwillingness to change anti-hypertensive medication by the attending Nephrologist or patient Recent acute kidney injury (>50% increase in serum creatinine in preceding 30 days) Previous kidney replacement therapy (kidney transplant, hemodialysis or peritoneal dialysis) Recent myocardial infarction, stroke, heart failure (in preceding 30 days) Recent injurious fall requiring hospitalisation (in preceding 30 days) Concomitant major illness / comorbidity that may result in death in the next 6 months Participation in another study that is likely to affect BP levels Inability to provide consent due to cognitive impairment.