Nocturnal hypertension is prevalent in those with chronic kidney disease (CKD). 1,2 However, the mechanisms for nocturnal hypertension in the CKD population remain under investigation and social determinants of health (SDoH), the “conditions in which people are born, grow, live, work, and age,”3 may play a role. SDoH can augment psychosocial stress which in turn can activate physiological pathways that contribute to hypertension.4 Chronic stressors enhance activation of the sympathetic nervous system, an important regulator of circadian cardiovascular variation5,6 and this excess activation could specifically predispose individuals with CKD to nocturnal hypertension and accelerate hypertension-induced target organ damage.