DD-study: Diet or Diuretics for Salt-sensitivity in Chronic Kidney Disease (DD)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Rotterdam, Netherlands
- ErasmusMC
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > 18 years.
- CKD stage 3 or 4 (MDRD-GFR 15-60 ml/min)
- Use of any anti-hypertensive drugs
- No anti-hypertensive drugs but an average office systolic blood pressure > 140 mmHg (as measured by datascope)
Exclusion Criteria:
- Salt-wasting CKD
- Nephrotic syndrome
- Pregnant or breastfeeding women
- Life expectancy < 6 months
- Severe heart failure (NYHA III or IV) or liver cirrhosis with ascites and the inability to withdraw diuretics
- Rapidly declining kidney function with high likelihood of dialysis or kidney transplantation in the coming 4 months
- Kidney transplant recipients
- Use of immunosuppressive drugs
- Use of non-steroidal anti-inflammatory drugs
- Previous intolerance or allergy to hydrochlorothiazide or amiloride
- Serum sodium < 135 mmol/l
- Serum potassium < 3.5 mmol/l or > 5.0 mmol/l
- Inability to adhere to the study protocol (due to language, incapacitated subjects, subjects with intellectual disability)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Diuretic treatment
Patients receive amiloride and hydrochlorothiazide
|
Combined with hydrochlorothiazide
Combined with amiloride
|
|
Active Comparator: Low-sodium diet
Patients are put on a low-sodium diet (60 mmol/day)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
24 hour blood pressure
Time Frame: Two weeks after start of each intervention
|
Two weeks after start of each intervention
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ewout J Hoorn, MD, PhD, Erasmus Medical Center
Publications and helpful links
General Publications
- McMahon EJ, Campbell KL, Bauer JD, Mudge DW, Kelly JT. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2021 Jun 24;6(6):CD010070. doi: 10.1002/14651858.CD010070.pub3.
- Agarwal R, Sinha AD, Pappas MK, Ammous F. Chlorthalidone for poorly controlled hypertension in chronic kidney disease: an interventional pilot study. Am J Nephrol. 2014;39(2):171-82. doi: 10.1159/000358603. Epub 2014 Feb 11.
- Meng L, Fu B, Zhang T, Han Z, Yang M. Salt sensitivity of blood pressure in non-dialysis patients with chronic kidney disease. Ren Fail. 2014 Apr;36(3):345-50. doi: 10.3109/0886022X.2013.866008. Epub 2013 Dec 17.
- McMahon EJ, Campbell KL, Bauer JD, Mudge DW. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2015 Feb 18;(2):CD010070. doi: 10.1002/14651858.CD010070.pub2.
- Slagman MC, Nguyen TQ, Waanders F, Vogt L, Hemmelder MH, Laverman GD, Goldschmeding R, Navis G. Effects of antiproteinuric intervention on elevated connective tissue growth factor (CTGF/CCN-2) plasma and urine levels in nondiabetic nephropathy. Clin J Am Soc Nephrol. 2011 Aug;6(8):1845-50. doi: 10.2215/CJN.08190910. Epub 2011 Jul 22.
- Levy Yeyati N, Fellet A, Arranz C, Balaszczuk AM, Adrogue HJ. Amiloride-sensitive and amiloride-insensitive kaliuresis in advanced chronic kidney disease. J Nephrol. 2008 Jan-Feb;21(1):93-8.
- Bovee DM, Visser WJ, Middel I, De Mik-van Egmond A, Greupink R, Masereeuw R, Russel FGM, Danser AHJ, Zietse R, Hoorn EJ. A Randomized Trial of Distal Diuretics versus Dietary Sodium Restriction for Hypertension in Chronic Kidney Disease. J Am Soc Nephrol. 2020 Mar;31(3):650-662. doi: 10.1681/ASN.2019090905. Epub 2020 Jan 29.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urologic Diseases
- Renal Insufficiency
- Kidney Diseases
- Renal Insufficiency, Chronic
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Natriuretic Agents
- Membrane Transport Modulators
- Diuretics
- Sodium Channel Blockers
- Diuretics, Potassium Sparing
- Sodium Chloride Symporter Inhibitors
- Acid Sensing Ion Channel Blockers
- Epithelial Sodium Channel Blockers
- Hydrochlorothiazide
- Amiloride
Other Study ID Numbers
Other Study ID Numbers
- NL54748.078.15
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