Diuretic Testing in Chronic Kidney Disease

Launched by ERASMUS MEDICAL CENTER · Feb 18, 2025

Keywords

ClinConnect Summary

This clinical trial is focusing on how diuretic testing can help predict the progression of chronic kidney disease (CKD) in patients. Diuretics are medications that help the body get rid of excess fluid. The researchers want to find out if poorer results from a diuretic test indicate that a person's kidney disease may worsen over time. To see how these results differ, they will also compare patients with CKD to healthy individuals with normal kidney function.

If you or a family member have chronic kidney disease, specifically at stage G3 (meaning your kidneys are moderately affected), you may be eligible to participate. Participants will receive two diuretic medications, bumetanide and hydrochlorothiazide, and will provide blood and urine samples for testing. It's important to know that certain conditions, like severe heart failure or specific kidney issues, may disqualify someone from joining the trial. Overall, this study aims to gather valuable information that could help improve how chronic kidney disease is managed in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria for CKD subjects:
• • CKD stage G3 (creatinine-based eGFR 30-59 mL/min/1.73m2) during the last outpatient visit
• Inclusion Criteria for Healthy subjects:
• • • eGFR within the expected range for age (a decline of 1 ml/min/1.73 m2 per year starting from age 40 is considered the normal age-related decline in kidney function
• Exclusion Criteria:
• • Known intolerance or allergy to the diuretics
• • Current systemic chemotherapy for malignancy
• • Kidney transplant recipient
• • Use of calcineurin-inhibitors
• • Life expectancy \< 12 months
• • Current immunosuppressive treatment for glomerulonephritis
• • Incapacitated subjects or subjects who are deemed unfit to adequately adhere to instructions from the research team
• • Hypokalemia or hyperkalemia (K+ \< 3.0mmol/L or K+ \> 5.5 mmol/L) at inclusion visit
• • Hypo- or hypernatremia (Na+ \< 130 mmol/L or Na+ \> 150mmol/L) at inclusion visit
• • Inherited tubulopathy as the cause of CKD
• • Autosomal dominant polycystic or tubulointerstitial kidney disease causing CKD
• • Clinically relevant heart failure (New York Heart Association class III or IV)
• • Therapy-resistant hypertension, defined as systolic blood pressure \> 180mmHg at the inclusion visit
• • Current treatment with inhibitors of Organic anion transporters: probenecid, pravastatin, cimetidine, cephalosporins, acetazolamide \[22\]
• • Active hepatitis during last outpatient visit
• • Liver cirrhosis in advanced stage (Child-Pugh B or C)
• • Active drug- or alcohol abuse
• • Not being able to tolerate a 28-day washout of one of the drugs interfering with diuretic testing.
• • Women who are pregnant, breastfeeding, or planning on becoming pregnant before the test day