Spironolactone in CKD Enabled by Chlorthalidone: PILOT
Status:
Recruiting
Trial end date:
2022-12-12
Target enrollment:
Participant gender:
Summary
Highly prevalent among patients with chronic kidney disease (CKD) and poorly controlled blood
pressure (BP), is a modifiable risk factor to abrogate both kidney failure progression and
cardiovascular (CV) disease. Spironolactone (SPL), a mineralocorticoid receptor antagonist,
is widely used to treat resistant hypertension, however one of the most common side effects
is an increase of serum potassium (K). This side effect occurs frequently in those who suffer
from CKD. Alternatively, chlorthalidone (CTD) is a thiazide-like diuretic used for treating
hypertension and decreases serum K. In this pilot study, our goal is to assess whether the
combination of SPL and CTD can improve BP control, while also reducing the risk of
hyperkalemia over a period of 12 weeks. We hypothesize that among patients with CKD and
poorly controlled hypertension, compared to SPL and placebo, treatment over 12 weeks with CTD
will counter the hyperkalemia effect of SPL, and therefore the combination of SPL with CTD
will result in a lower BP. This pilot study will be performed at Richard L. Roudebush VA in
Indianapolis, Indiana.