Renal and Systemic Vascular Resistance in Chronic Kidney Disease (CKD)

University of Aarhus83 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Chronic Kidney Insufficiency Hypertension Vasodilation

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 YearsHealthy volunteers:

Medical Language ↔ Plain English

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.

Outcomes

Primary Outcomes

Change in glomerular filtration rate between the two treatment arms.

Time frame: Measured at baseline and after 18 months of treatment

Secondary Outcomes

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.

Time frame: 18 months