Nighttime Losartan in Continous Ambulatory Peritoneal Dialysis (NVCAPD)
Status:
Not yet recruiting
Trial end date:
2023-12-01
Target enrollment:
Participant gender:
Summary
Hypertension is one of the most important independent risk factors for the prognosis of
continous ambulatory peritoneal dialysis patients. The incident rate is high and the control
rate is low. Nocturnal hypertension has been paid more attention in recent years. Compared to
daytime blood pressure, nocturnal blood pressure is an independent and efficient prognostic
indicator of hypertensive deaths and cardiovascular events, but it is lack of evidence about
its impact on prognosis in peritoneal dialysis patients and the effective treatment program.
Our previous cohort study suggests that the incidence of nocturnal hypertension in patients
with chronic kidney disease is up to 71.22%, with a significant increase as the decline of
renal function, and more severe target organ damage in patients with nocturnal hypertension:
the decrease of glomerular filtration rate, left ventricular hypertrophy, and the increase of
all cause death and cardiovascular death. Our small sample size study show that night time
antihypertensive drugs can better control blood pressure and delay the development of left
ventricular hypertrophy. These preliminary results suggest that nocturnal hypertension is
closely related to the prognosis of chronic renal disease. Taking antihypertensive drugs at
night is one of the options for controlling nocturnal hypertension. However, it is not clear
whether taking antihypertensive drugs at night can improve the prognosis of maintenance
peritoneal dialysis patients with nocturnal hypertension. To this end, the investigators
collect continous ambulatory peritoneal dialysis patients with nocturnal hypertension, and
propose a time selective use of losartan to intervene in nocturnal hypertension. By comparing
the difference in the effects of losartan on the prognosis of maintenance peritoneal dialysis
patients during the day or night, to further clarify the role of nocturnal hypertension in
the prognosis of maintenance peritoneal dialysis patients, whether controlling nocturnal
hypertension can improve the prognosis of maintenance peritoneal dialysis patients. The
completion of study will optimize the prevention and treatment of hypertension in maintenance
peritoneal dialysis patients, and provide an evidence for precise prevention and treatment of
nocturnal hypertension in maintenance peritoneal dialysis patients.