Chronic Kidney Insufficiency, Hypertension, Vasodilation
Conditions
Brief summary
Patients with reduced kidney function have a higher risk of heart disease and death. Studies have shown that blood vessels in patients with hypertension change with a decrease of lumen size and growth of the vessel wall. By treating patients with antihypertensive certain medication vessel lumen and walls normalize. Treating hypertension in patients with chronic kidney disease slows the progression of kidney function loss. The aim is to compare different degrees of antihypertensive medication in patients with chronic kidney disease and hypertension will slow the progression of kidney loss.
Interventions
DRUGBeta-blocker, ACE-inhibitor
Beta-blocker: 50- 100 mg 1-2 times a day. ACEi: 5-10 mg once a day
DRUGCalcium Channel Blockers, ACE-Inhibitor
Calcium Channel Blockers: 5-10 mg a day. ACEi: 5-10 mg a day
Sponsors
University of Aarhus
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
* eGFR 15-60 ml/min for at least 3 months * Blood pressure \> 130 mmHg systolic og \>80 mmHg diastolic (patients without antihypertensive treatment or in treatment with Beta-blockers, ACEi, ARBs or CCB not in maximum dosi). * Blood pressure \< 130 mmHg systolic og \< 80 mmHg diastolic (patients receiving Beta-blockers, ACEi, ARBs og CCB). * Fertile women using safe contraceptives
Exclusion criteria
* Ultrasound verified Polycystic Kidney Disease (ADPKD) * Claustrophobia (MRi scan). * Contraindications to MRi. * Pregnancy or wish to become pregnant in the study period. * Nephrotic syndrome with gross edema. * Known allergy to any study medication. * Blood pressure \< 130 mmHg systolic or \< 80 mmHg diastolic without antihypertensive treatment. * Blood pressure \> 130 mmHg systolic or \> 80 mmHg diastolic and in maximum dosages of all three Beta-blockers, ACEi (ARBs) and CCB.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in glomerular filtration rate between the two treatment arms. | Measured at baseline and after 18 months of treatment |
Secondary
| Measure | Time frame |
|---|---|
| Changes in glomerular filtration rate stratified after changes in pulse wave velocity, renal vascular resistance and forearm minimal resistance at baseline and after 18 months of treatment. | 18 months |
Countries
Denmark
Outcome results
None listed