Hypertensive patients with CKD under the treatment of ARB
Conditions
Interventions
ACE-inhibitor is added on pretreatment(ARB)
Cilnidipine is added on pretreatment(ARB)
Sponsors
Tokyo Women's Medical University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Hypertensive patients with CKD fulfilled following conditions during observation period will be enrolled (targeted) 1. SBP>=130mmHg or DBP>=80mmHg 2. Treated by ARB more than 1 month, and not treated by CCB or ACE inhibitor last 1 month 3. Written informed consent for this study is obtained 4. Obvious Renal damage 1) Proteinuria, pathology diagnostic imaging, urine or blood tests etc. 2) GFR=<60mL/min/1.73m2
Exclusion criteria
Exclusion criteria: Following patients will be excluded from this study 1.Hypertensive emergency that requires other than oral administration of antihypertensives 2.Past history of severe adverse effect by CCB, ARB, or ACE inhibitor 3.Cerebrovascular disease occured within 6 months 4.Severe liver or renal dysfunction 5.Sever heart failure (NYHA class >= 3), severe arrhythmia (frequent ventricular or atrial extrasystole, sustained ventricular tachycardia, atrial arrhythmia with severe tachycardia, atrial fibrillation or flutter with severe bradycardia, sick sinus syndrome with severe bradycardia, atrio-ventricular block with severe bradycardia), myocardial infarction within 6 months 6. Malignancy 7. Pregnant, possible to be pregnant, or willing to be pregnant 8. Scheduling the operation 9. Patients who are inadequate by physician's decision
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| 1 Change in CKD stage 2 Serum Cr 3 Estimated GFR 4 Serum beta2-microglobulin 5 Urinary L-FABP 6 Serum CRP 7 Plasma BNP 8 Echocardiography 9 ICG 10 PAI-1 11 Serum ADMA 12 Serum uric acid 13 Cardiovascular events Cerebrovascular and cardiovascular mortality fatal myocardial infarction, fatal heart failure, sudden death, fatal stroke, other cardiovascular death Hospitalization due to cerebrovascular and cardiovascular disease nonfatal myocardial infarction, angina, heart failure, cerebral bleeding, cerebral infarction, transient cerebral ishemic attack 14 Blood pressure lowering effect 15 Heart rate 16 Safety | — |
Primary
| Measure | Time frame |
|---|---|
| 1. Change in urinary protein 2. Change in baPWV | — |
Countries
Japan
Contacts
Public ContactTetsuya Ogawa
Tokyo Women's Medical University Department of Medicine, Kidney Center
Outcome results
None listed