Do you prefer maximizing fluid removal during dialysis or starting new antihypertensive medications for patients with ESKD on intermittent hemodialysis who are chronically hypertensive?  

Definitely maximizing fluid removal. The problem is that it is not always easy to achieve. Many times, there is a delayed response (fluid is removed, and it takes 2-3 months for the blood pressure to come down). If I hit a roadblock in removing fluid, then I adjust the medications.