Peralta CA, Frigaard M, Rolon L, et al. - Whether screening for CKD employing a triple-marker approach (creatinine, cystatin C, and albumin/creatinine ratio), followed by education and guidance, would be a feasible and effective strategy to improve the care of hypertensive veterans in primary care, was determined in this pilot, pragmatic, cluster-randomized trial. Researchers utilized the electronic health record for recognition, enrollment, intervention delivery, and outcome determination. They randomly allocated 1,819 veterans without diabetes but with hypertension (41 clusters) to either CKD screening followed by patient and provider education, or screening, education, plus pharmacist comanagement, or to usual care. Following 1 year, change in systolic BP was −1 mm Hg, −2 mm Hg, and −2 mm Hg in the usual care arm, screen-educate arm, and in the screen-educate plus pharmacist arm, respectively. Starting a renin-angiotensin system inhibitor or diuretic was reported in higher proportions of participants in the intervention arms, in as-treated analyses. A highly efficient identification, enrollment, and intervention delivery, was afforded by the pragmatic design. As a result of limited ability to recognize appointments, there were inadequate between-arm variations in CKD testing rates to ascertain if screening improves clinical results.