This study is not yet accepting patients

ACEi ARB Withdrawal in CKD Patients

a study on Chronic Kidney Disease Kidney Disease Blood Pressure Angiotensin-converting Enzyme Inhibitor Angiotensin Receptor Blockers

Summary

Eligibility
for people ages 18 years and up (full criteria)
Location
at San Francisco, California
Dates
study started
estimated completion
Principal Investigator
by Elaine Ku
Headshot of Elaine Ku
Elaine Ku

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, Chronic Renal Insufficiency, 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

  • UCSF
    San Francisco California 94143 United States

Lead Scientist at UCSF

  • Elaine Ku
    The global context of my research program focuses on understanding differences in the epidemiology, clinical management, and outcomes of children versus adults with kidney disease and the conduct of clinical trials to test interventions (such as blood pressure control) that will improve survival of patients with kidney disease.

Details

Status
not yet accepting patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, San Francisco
ID
NCT03957161
Study Type
Interventional
Participants
Expecting 60 study participants
Last Updated