Diuretics and Volume Overload in Early CKD
Almost 15% of Americans have chronic kidney disease (CKD), with an even higher rate in Veterans due to common risk factors such as high blood pressure and diabetes. People with CKD have a high risk of cardiovascular (CV) diseases, such as heart attacks, heart failure, and strokes. Extra fluid in the body, called volume overload, may lead to CV disease in people with CKD. It is unknown if volume overload develops in the earliest stages of CKD, when treating it with common, inexpensive medicines called diuretics may improve long-term CV outcomes. This study will lay important groundwork to answer this question in Veterans with early CKD by comparing two ways to measure volume overload and studying the change in common symptoms like fatigue and short-term CV function after treatment with diuretic medicines.
Conditions:
🦠 Chronic Kidney Disease 🦠 Hypertension
🗓️ Study Start (Actual) 1 February 2023
🗓️ Primary Completion (Estimated) 1 July 2025
✅ Study Completion (Estimated) 1 July 2025
👥 Enrollment (Estimated) 46
🔬 Study Type INTERVENTIONAL
📊 Phase PHASE4
Locations:
📍 Houston, Texas, United States

📋 Eligibility Criteria

Description

    Inclusion Criteria:

    • * Male or female Veterans age 18 years or older. There will be no upper age limit.
    • * The presence of CKD stages 1, 2, or 3, as defined below by Kidney Disease Improving Global Outcomes guidelines, for a period of at least 3 months.
    • * Stage 1: eGFR 90 mL/min/1.73 m2 and spot urine albumin-to-creatinine ratio 30 mg/g.
    • * Stage 2: eGFR 60-89 mL/min/1.73 m2 and spot urine albumin-to-creatinine ratio 30 mg/g.
    • * Stage 3: eGFR 30-59 mL/min/1.73 m2.
    • * Measured blood pressure either \>140 mmHg systolic or \>90 mmHg diastolic at the two most recent clinic visits.
    • * Able to understand and sign informed consent after the nature of the study has been fully explained.

    Exclusion Criteria:

    • * Unable to understand or provide informed consent.
    • * Unwilling or unable to participate in the protocol or comply with any of its components.
    • * CKD stages 4-5, defined as eGFR \<30 mL/min/1.73 m2.
    • * Receiving chronic hemodialysis or peritoneal dialysis.
    • * Recipient of a kidney transplant.
    • * Serum potassium \<3.5 mEq/L at baseline.
    • * Known left ventricular ejection fraction \<40% on visual estimate based on chart review of available echocardiogram data.
    • * Known hepatic cirrhosis.
    • * Major limb amputation.
    • * Known pregnancy.
    • * Presence of a pacemaker or defibrillator.
Ages Eligible for Study: 18 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: No

🗓️ Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

  • First Submitted 1 December 2021
  • First Submitted that Met QC Criteria 16 December 2021
  • First Posted 29 December 2021

Study Record Updates

  • Last Update Submitted that Met QC Criteria 3 January 2024
  • Last Update Posted 5 January 2024
  • Last Verified January 2024