Actively Recruiting

Phase 4
Age: 18Years +
All Genders
NCT06256991

Potassium Correction for RAAS Optimization in Chronic Kidney Disease

Led by University Medical Center Groningen · Updated on 2025-12-19

44

Participants Needed

1

Research Sites

191 weeks

Total Duration

On this page

Sponsors

U

University Medical Center Groningen

Lead Sponsor

A

Amsterdam University Medical Center

Collaborating Sponsor

AI-Summary

What this Trial Is About

The goal of this placebo-controlled, double-blinded cross-over trial is to test whether patiromer, compared with placebo, better enables up-titration of RAAS-blocker treatment in patients with chronic kidney disease stage 3b/4. The main questions it aims to answer are: * Does patiromer allow uptitration of irbesartan, resulting in a significant reduction in albuminuria and blood pressure? * Does patiromer allow uptitration of irbesartan, resulting in a significant reduction in blood pressure? The trial contains the following interventions: * Participants will be switched from their ACEi/ARB to a standardised dose of irbesartan (150 mg/d). * During two 12-week study periods, participants will receive either patiromer 8.4 g/d or placebo. The order of study periods is randomized. * At the start of each study period irbesartan will be up-titrated to 300 mg/d. * After 1 and 6 weeks, at both periods, plasma potassium will be measured and the irbesartan dose will be reduced to 150 mg/d in case plasma potassium exceeds 5.0 mmol/L. * At 12 weeks from the start of the study period, the endpoints will be assessed. * Between the two study periods, there is a 6-week washout. Irbesartan dose during the wash-out period will be 150mg/d. After washout, participants will switch from the patiromer arm to the placebo arm or vice versa.

CONDITIONS

Official Title

Potassium Correction for RAAS Optimization in Chronic Kidney Disease

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 218 years
  • Chronic kidney disease stage 3b-4 with eGFR 15-44 mL/min/1.73 m2
  • Albumin-creatinine ratio greater than 3 mg/mmol, or proteinuria greater than 0.05 g/24 hours, or protein-creatinine ratio greater than 5 mg/mmol
  • Systolic blood pressure greater than 130 mmHg or use of one or more antihypertensive drugs
  • Serum potassium level between 4.0 and 5.0 mmol/L
  • Currently on sub-maximal dose ACE inhibitor or angiotensin receptor blocker
Not Eligible

You will not qualify if you...

  • Prior ACEi/ARB dose reduction due to a drop in eGFR by more than 25% in the last year
  • History of severe hyperkalemia (greater than 6.0 mmol/L) in the last year
  • Pregnancy or breastfeeding
  • Life expectancy less than 12 months
  • Use of lithium, potassium-sparing diuretics, potassium supplements, trimethoprim, or NSAIDs
  • Kidney transplant recipients or diagnosis of autosomal dominant polycystic kidney disease or other non-glomerular kidney disease

AI-Screening

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Trial Site Locations

Total: 1 location

1

University Medical Center Groningen

Groningen, Netherlands

Actively Recruiting

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Research Team

M

Martin de Borst, prof. dr.

CONTACT

C

Caspar van Lieshout, MD

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

TRIPLE

Allocation

RANDOMIZED

Model

CROSSOVER

Primary Purpose

TREATMENT

Number of Arms

2

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