Testing diuretics to predict kidney disease progression

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 aims to predict the progression of chronic kidney disease (CKD) through diuretic testing in affected patients. Participants will receive diuretics, specifically bumetanide and hydrochlorothiazide, followed by blood and urine collections to assess kidney function. The study will also compare results from CKD patients to healthy individuals to identify differences in kidney response. The primary focus is to determine if poorer diuretic test results correlate with faster progression of CKD.

Why it matters

Who can join: the full rules

Inclusion Criteria for CKD subjects:

* CKD stage G3 (creatinine-based eGFR 30-59 mL/min/1.73m2) during the last outpatient visit

Inclusion Criteria for Healthy subjects:

• eGFR within the expected range for age (a decline of 1 ml/min/1.73 m2 per year starting from age 40 is considered the normal age-related decline in kidney function

Exclusion Criteria:

* Known intolerance or allergy to the diuretics
* Current systemic chemotherapy for malignancy
* Kidney transplant recipient
* Use of calcineurin-inhibitors
* Life expectancy \< 12 months
* Current immunosuppressive treatment for glomerulonephritis
* Incapacitated subjects or subjects who are deemed unfit to adequately adhere to instructions from the research team
* Hypokalemia or hyperkalemia (K+ \< 3.0mmol/L or K+ \> 5.5 mmol/L) at inclusion visit
* Hypo- or hypernatremia (Na+ \< 130 mmol/L or Na+ \> 150mmol/L) at inclusion visit
* Inherited tubulopathy as the cause of CKD
* Autosomal dominant polycystic or tubulointerstitial kidney disease causing CKD
* Clinically relevant heart failure (New York Heart Association class III or IV)
* Therapy-resistant hypertension, defined as systolic blood pressure \> 180mmHg at the inclusion visit
* Current treatment with inhibitors of Organic anion transporters: probenecid, pravastatin, cimetidine, cephalosporins, acetazolamide \[22\]
* Active hepatitis during last outpatient visit
* Liver cirrhosis in advanced stage (Child-Pugh B or C)
* Active drug- or alcohol abuse
* Not being able to tolerate a 28-day washout of one of the drugs interfering with diuretic testing.
* Women who are pregnant, breastfeeding, or planning on becoming pregnant before the test day

Where it's running

• Erasmus MC
  Rotterdam, South Holland, Netherlands Recruiting

Study contacts

• Principal investigator: Ewout J. Hoorn, MD, PhD — Erasmus Medical Center
• Study coordinator: Sebastian B Beckmann, MD
• Email: s.beckmann@erasmusmc.nl
• Phone: +31 6 39022349

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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.