Improving blood pressure management in patients with chronic kidney disease

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial investigates the effectiveness of intensifying blood pressure-lowering treatments, specifically using diuretics, compared to standard management in patients with moderate to severe chronic kidney disease (CKD) who have uncontrolled hypertension. The study aims to determine if a tailored antihypertensive algorithm can lead to better blood pressure control and improved health outcomes in this high-risk population. Participants will be monitored for their blood pressure levels and overall kidney function throughout the trial.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Male or female \>=18 years with a clinical frailty score ≤5 for patient aged over 80
* Advanced or moderate chronic kidney disease (eGFR 15 to 44.9 mL/min/1.73m² using CKD-EPI formula)
* Arterial hypertension treated with at least one blood pressure lowering drug therapy among blockers of the renin-angiotensin system (ACEi or ARB), at the maximal posology tolerated by the patients stable since at least one month. Other blood pressure lowering drug therapies are tolerated in combination with or in the event of intolerance to ACE inhibitors or ARBs.
* Uncontrolled office BP
* Uncontrolled office BP (\>140 and/or 90 mmHg) confirmed by home blood pressure monitoring (\>135 and/or 85 mmHg) or Day-time Ambulatory Blood Pressure Monitoring
* Participant covered by or entitled to social security
* Written informed consent obtained from the participant

Exclusion Criteria:

* Patient following any measures of legal presentation
* Pregnant or breastfeeding woman
* woman of childbearing without a highly effective contraceptive measure (combined or progestogen-only hormonal contraception associated with inhibition of ovulation, intrauterine device or intrauterine hormone-releasing system)
* Clinical signs of hypovolemia
* Symptomatic orthostatic hypotension
* Hyponatremia (\<130 mmol/L)
* Dyskalemia (\<3,5 mmol/L or \>5,5 mmol/L)
* Major adverse cardiovascular event during the last three months: myocardial infarction, heart failure hospitalization, stroke
* Current medical history of cancer requiring chemotherapy
* Solid organ transplantation
* Two or more diuretic agents (loop diuretic, thiazides and thiazide-like diuretics)
* Mineralocorticoid receptor antagonists
* Autosomal dominant polycystic kidney disease treated with Tolvaptan
* Contraindication to diuretics involved in the algorithm
* Severe heart failure (NYHA III\_IV)
* Cirrhosis Child B-C

Where it's running

• Department of Nephrology, University Hospital of Angers
  Angers, France Recruiting
• Department of Nephrology, University Hospital of Bordeaux
  Bordeaux, France Recruiting
• AUB Santé foundation, Brest
  Brest, France Recruiting
• Department of Nephrology, University Hospital of Brest
  Brest, France Recruiting
• Department of Nephrology, Hospital of Chalon-sur-Saône
  Chalon-sur-Saône, France Recruiting
• Department of Nephrology, Hospital of Chartres
  Chartres, France Recruiting

Study contacts

• Principal investigator: Bénédicte Sautenet, MD — University Hospital, Tours
• Study coordinator: Bénédicte Sautenet, MD
• Email: benedicte.sautenet@gmail.com
• Phone: 02.34.37.96.86

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Baxdrostat for Uncontrolled Hypertension in Chinese Adults

  This study tests whether baxdrostat 2 mg once daily can lower 24-hour systolic blood pressure in adults with uncontrolled hypertension who are already on multiple hypertension medications.

  Recruiting Phase 3 AstraZeneca · Beijing and 50 other locations · NCT07686120

• SAL0140 at different doses for uncontrolled hypertension

  This trial tests whether SAL0140 at various doses can help people with uncontrolled high blood pressure compared to placebo.

  Recruiting Phase 2 Shenzhen Salubris Pharmaceuticals Co., Ltd. · Beijing, Beijing Municipality · NCT07654140

• Biomarker-guided treatment strategy for chronic kidney disease

  This trial will test whether using urine biomarkers to guide adding dapagliflozin, finerenone, and/or semaglutide can better reduce albuminuria and protect kidneys in adults with CKD.

  Recruiting Phase 4 Steno Diabetes Center Copenhagen · Herlev and 3 other locations · NCT07239570

• Algae supplements for heart risk markers and gut health

  This trial will test whether daily supplements of spirulina or Gelidium corneum change gut microbes and improve heart‑disease risk markers in adults over 50 with cardiovascular disease, diabetes, or related conditions.

  Recruiting Universidade do Porto · Porto · NCT07173062

• Modified-release RTN-001 for adults with uncontrolled high blood pressure

  This trial will test whether taking a daily modified-release RTN-001 capsule lowers blood pressure in adults whose hypertension remains uncontrolled despite at least two blood-pressure medicines.

  Recruiting at 43 sites Phase 2 Retension Pharmaceuticals. Inc. · Alexander City, Alabama and 43 other locations · NCT07142356

• Iloperidone for adults with uncontrolled high blood pressure

  We are testing whether iloperidone can lower blood pressure in adults whose blood pressure stays high despite at least 8 weeks of one or more blood pressure medications.

  Recruiting at 18 sites Phase 2 Vanda Pharmaceuticals · Phoenix, Arizona and 27 other locations · NCT07090161

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.