Comparing Diuretic-Based Blood Pressure Treatment to Usual Care for Uncontrolled Hypertension in Moderate to Severe Chronic Kidney Disease A Phase 3 Randomized Trial

What this Trial Is About

Chronic kidney disease CKD is a significant global health concern, with hypertension being the leading risk factor for death, cardiovascular problems, and progression to end-stage kidney disease in these patients. Lowering blood pressure is known to reduce these risks, but the best second-line treatment after initial therapy with ACE inhibitors or angiotensin receptor blockers ARBs is unclear. This study aims to compare a diuretic-based blood pressure lowering approach to usual care in patients with moderate to severe CKD and uncontrolled hypertension. Participants are assigned to one of two groups one group receives blood pressure management guided by a diuretic-based algorithm, while the other group follows the usual care provided by their clinicians, which may include pharmacological or non-pharmacological therapies. The study is a randomized, open-label, phase 3 trial using a parallel design. Treatment adjustments are made according to the assigned strategy, and the study will continue for up to 36 months to observe outcomes. During the study, participants will be monitored for kidney function decline, cardiovascular events, all-cause mortality, and blood pressure control. Researchers will assess changes in kidney filtration rate, proteinuria, diuretic use, and quality of life over time. Regular evaluations will include blood pressure measurements and other clinical assessments to track the effectiveness of the treatment strategies. The total participation time can last up to three years, with ongoing monitoring of health outcomes throughout this period.

Intensification of Blood Pressure Lowering Therapeutics Based on Diuretics Versus Usual Management for Uncontrolled Hypertension IN Patients With Moderate to Severe Chronic Kidney Disease