Guiding Optimal Blood Pressure Management in Peritoneal Dialysis Pilot Trial (GOAL-BP)
The GOAL-BP pilot study will help determine whether a study comparing two blood pressure goals can be carried out in adults with end-stage kidney disease and high blood pressure who receive peritoneal dialysis. The main questions it aims to answer are whether eligible patients can be recruited for the study.
Researchers will compare two goals for the top blood pressure number (systolic blood pressure): below 120 mmHg versus below 140 mmHg.This pilot study will help plan a larger trial in the future.
Participants will:
- Be assigned by chance to one of the two blood pressure goals.
- Have their blood pressure measured at clinic visits about every two weeks.
- Work with their kidney doctor on recommended changes to fluid management, peritoneal dialysis treatment, or blood pressure medicines to reach their assigned goal.
- Be part of the study for about four and a half months.
研究概览
地位
地位
条件
条件
干预/治疗
干预/治疗
详细说明
Peritoneal dialysis (PD) use among patients with end-stage kidney disease (ESKD) has increased substantially over the last decade. Yet there are no randomized clinical trials evaluating blood pressure (BP) targets in patients receiving PD.
GOAL-BP is a pilot study that will evaluate the feasibility of enrolling patients receiving PD to two systolic blood pressure targets (SBP): <120mmHg vs. <140 mmHg.
BP management will be guided by standardized clinic measurements. The study team will make recommendations to the treating nephrologist to achieve the goal SBP using a stepwise approach that addresses volume status before recommending changes to antihypertensive medications. The treating nephrologist will make the final decision about any changes to clinical care.
研究类型
研究类型
注册 (估计的)
注册
阶段
阶段
- 不适用
联系人和位置
学习联系方式
学习联系方式
- 姓名:Kashvi Gupta, MD, MPH
- 电话号码:734-546-4545
- 邮箱:Kashvi.Gupta@ucsf.edu
学习地点
-
-
California
-
San Francisco、California、美国、94110
- 尚未招聘
- Zuckerberg San Francisco General Hospital
-
接触:
- Kashvi Gupta, MD, MPH
- 电话号码:734-546-4545
- 邮箱:kashvi.gupta@ucsf.edu
-
San Francisco、California、美国、94014
- 招聘中
- Satellite Healthcare - Daly City
-
接触:
- Kashvi Gupta, MD, MPH
- 电话号码:734-546-4545
- 邮箱:kashvi.gupta@ucsf.edu
-
San Francisco、California、美国、94118
- 招聘中
- Satellite Healthcare - San Francisco Geary
-
接触:
- Kashvi Gupta, MD, MPH
- 电话号码:734-546-4545
- 邮箱:kashvi.gupta@ucsf.edu
-
-
参与标准
资格标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Age ≥ 18 years.
- Undergoing regular PD for treatment of ESKD.
- On PD for ≥ 4 months. (We do not plan to enroll patients within the first 3 months of PD initiation because there can be large fluctuations in volume status and BP readings before patient coming into more of a steady state. We then require participants to have at least 1 month of BP data to allow calculation of an average pre-enrollment BP for screening for study entry.)
- Diagnosis of HTN defined as being on antihypertensive medications or having routine clinic SBP ≥ 140 mmHg averaged over prior one month to screening.
- Able to measure brachial BP.
Exclusion Criteria:
- Planned transplant or HD transition < 4.5 months (the duration of study).
- Estimated life expectancy < 4.5 months (also determined by asking the treating nephrologist).
- Participation in another clinical trial that may affect BP management.
- Pregnancy, anticipated pregnancy, or breastfeeding as this will limit the use of certain antihypertension medications in the study and pose additional risks to the patient and many pregnant patients are transitioned over to hemodialysis.
- Incarceration or institutionalized living which may prohibit measurement of home BP.
- Presence of a condition or abnormality that, in the opinion of the study team or treating nephrologist, would compromise the safety of the patient or the quality of the data.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
手臂数量
武器和干预
参与者组/臂参与者组/臂 |
干预/治疗干预/治疗 |
|---|---|
|
其他:Intervention
Target systolic blood pressure <120 mmHg |
The target SBP <120 mmHg will be operationalized as SBP 100-119 mmHg in the intervention arm. For volume control, the patient's dry weight target will be adjusted downward and will be attempted to be achieved through greater PD ultrafiltration, dietary fluid/salt restriction, or diuretics. Once patients are deemed euvolemic based on the assessment of the treating nephrologist, antihypertensive medications will be added or adjusted in a standardized sequence: priority is given to angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) due to data about this class of agents being shown to better preserve residual kidney function. Other medications are recommended to be added as indicated to maintain SBP <120 mmHg in the interventional arm. If SBP were <100 mmHg at one visit or <105 mmHg at two consecutive visits, BP medications will be reduced to keep SBP in the range of 100 to 119 mmHg, to avoid hypotensive episodes. |
|
其他:Control
Target systolic blood pressure <140 mmHg |
The target SBP <140 mmHg will be operationalized as SBP 130-139 mmHg. For volume control, the patient's dry weight target will be adjusted downward and will be attempted to be achieved through greater PD ultrafiltration, dietary fluid/salt restriction, or diuretics. Once patients are deemed euvolemic based on the assessment of the treating nephrologist, antihypertensive medications will be added or adjusted in a standardized sequence: priority is given to angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) due to data about this class of agents being shown to better preserve residual kidney function. Other medications are recommended to be added as indicated to maintain <140 mmHg in the control arm. If SBP were <130 mmHg at one visit or <135 mmHg at two consecutive visits, BP medications will be tapered/discontinued to keep SBP in the range of 130 to 139 mmHg. |
研究衡量的是什么?
主要结果指标
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Feasibility of enrolling participants
大体时间:4.5 months
|
The primary feasibility endpoint is the screen-to-enrollment ratio, calculated as the number of participants randomized divided by the number of potentially eligible individuals screened during the recruitment period. Physician refusal and patient refusal rates will also be reported. |
4.5 months
|
次要结果测量
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Retention of study participants
大体时间:4.5 months
|
The duration a study participant will be in the study, from the baseline visit. |
4.5 months
|
|
Physician adherence to protocol recommendations for achieving target SBP
大体时间:4.5 months
|
4.5 months
|
|
|
Patient adherence to home BP measurements and recommended adjustments in dialysis prescription and medications
大体时间:4.5 months
|
Adherence will be assessed by the number of times a patient follows the recommendations across BP measurements, changes in dialysis prescription, and medications. |
4.5 months
|
|
SBP achieved in each arm
大体时间:4.5 months
|
4.5 months
|
|
|
Change in residual kidney function under two different SBP targets
大体时间:4.5 months
|
Residual kidney function is assessed by 24-hour urine collection as per the dialysis unit protocol and indication. These will be assessed to determine any changes. |
4.5 months
|
|
Safety of targeting SBP <120 mmHg vs. <140 mmHg
大体时间:4.5 months
|
4.5 months
|
其他结果措施
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Qualitative themes identified from the end-of-study structured participant interviews
大体时间:4.5 months
|
Structured participant interviews will be administered by the study team to the patient to collect qualitative feedback, which will be organized into themes. |
4.5 months
|
合作者和调查者
调查人员
调查人员
- 首席研究员:Chi-yuan Hsu, MD, MS、University of California, San Francisco
研究记录日期
研究主要日期
学习开始 (估计的)
学习开始
初级完成 (估计的)
初级完成
研究完成 (估计的)
研究完成
研究注册日期
首次提交
首次提交
首先提交符合 QC 标准的
首先提交符合 QC 标准的
首次发布 (实际的)
首次发布
研究记录更新
最后更新发布 (实际的)
最后更新发布
上次提交的符合 QC 标准的更新
上次提交的符合 QC 标准的更新
最后验证
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
其他研究编号
- STUDY00000009
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
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研究美国 FDA 监管的设备产品
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