Summary

for people ages 18 years and up (full criteria)
at San Francisco, California
study started
estimated completion
Elaine Ku, MDRaymond Hsu, MD

Description

Summary

The American Heart Association guidelines for high blood pressure (BP) currently recommend using angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) as first-line therapy for patients with chronic kidney disease (CKD) stage 3 or above. However, the prevalence of ACEi and ARB use in patients with CKD stage 4 or 5 is low, and current BP guidelines acknowledge the lack of solid evidence to support the benefit of using these agents in advanced CKD.This study seeks to conduct a pilot trial to determine the safety and feasibility of ACEi and/or ARB continuation (intervention) versus withdrawal (control) in patients with advanced CKD.

Official Title

Angiotensin-converting Enzyme Inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB) Withdrawal in Patients With Advanced Chronic Kidney Disease

Keywords

Chronic Kidney Disease Blood Pressure Angiotensin-converting Enzyme Inhibitor Angiotensin Receptor Blockers Kidney Diseases Renal Insufficiency, Chronic Angiotensin-Converting Enzyme Inhibitors Continuation of ACEi and/or ARBs ACEi/ARB continuation ACEi/ARB withdrawal

Eligibility

You can join if…

Open to people ages 18 years and up

  • adults ≥18 years of age who meet the eGFR eligibility criteria, which will be determined based on whether participants have at least two eGFR in the last three months that are < 25 mL/min/1.73m2 or prior diagnosis of CKD (per electronic chart review) and at least one eGFR < 25 mL/min/1.73m2 in the past six months
  • receiving at least one antihypertensive medication at the time of the screening visit.

You CAN'T join if...

The investigators will exclude those who:

  • are or are planning to become pregnant, due to inability to take multiple classes of anti-hypertensive agents
  • are marginally housed, due to concerns regarding routine follow-up
  • are actively participating in a different interventional trial that may affect blood pressure
  • are unwilling to consent to participate
  • institutionalized individuals or prisoners
  • are actively abusing illicit drugs or alcohol
  • have a history of poor or doubtful compliance (e.g., frequently missed appointments)
  • have cognitive impairment prohibiting participation in the study
  • on dialysis at time of recruitment

Location

  • University of California, San Francisco
    San Francisco California 94143 United States

Lead Scientists

  • Elaine Ku, MD
    Medicine-Pediatrics Residency: University of Southern California Adult and Pediatric Nephrology Fellowship: University of California San Francisco Other Graduate Training: University of California San Francisco, MAS Collapse InterestsHypertension, Cardiovascular risk factors in chronic kidney disease, Transitional care, Disparities in transplant access and outcomes
  • Raymond Hsu, MD
    Dr. Raymond Hsu is a nephrologist who treats patients with a broad spectrum of kidney diseases in both inpatient and outpatient settings. In his clinic, he sees patients with all presentations of chronic kidney disease, difficult-to-control high blood pressure, glomerulonephritis, pregnancy-related kidney diseases and other conditions.

Details

Status
in progress, not accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, San Francisco
ID
NCT03957161
Phase
Phase 2
Study Type
Interventional
Last Updated