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The HALT polycystic kidney disease trials: design and implementation
Arlene B Chapman1, Vicente E Torres, Ronald D Perrone
1Emory University School of Medicine, Atlanta, GA 30322, USA. Arlene_chapman@emory.org
Clinical Journal of the American Society of Nephrology : CJASN
|January 22, 2010
Summary
The HALT PKD trials investigate lowering blood pressure and blocking the renin-angiotensin-aldosterone system to slow kidney disease in autosomal dominant polycystic kidney disease (ADPKD). These interventions aim to preserve kidney function and reduce adverse outcomes.
Area of Science:
- Nephrology
- Genetics
- Cardiovascular Medicine
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder leading to kidney failure.
- Hypertension is a major risk factor for kidney disease progression in ADPKD.
- Current treatments for ADPKD are limited, necessitating research into effective interventions.
Purpose of the Study:
- To evaluate the impact of intensive renin-angiotensin-aldosterone system (RAAS) blockade on kidney disease progression in hypertensive ADPKD patients.
- To assess the effect of different blood pressure (BP) control levels on slowing renal disease progression in ADPKD.
- To investigate novel endpoints, including kidney volume, for assessing treatment efficacy in ADPKD.
Main Methods:
- Multicenter, randomized, double-blind, placebo-controlled trials (PKD-HALT) involving 1018 hypertensive ADPKD patients.
- Two studies (A and B) stratified by estimated glomerular filtration rate (eGFR) to assess interventions in early and later stages of ADPKD.
- Comparison of combination angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) therapy versus ACEi monotherapy at varying BP control targets.
Main Results:
- The study design incorporates novel endpoints such as kidney volume changes to measure treatment effects.
- Home and office blood pressure measurements are utilized to accurately assess BP control.
- The impact of RAAS inhibition on kidney outcomes, patient safety, and quality of life is a key focus.
Conclusions:
- The HALT PKD trials aim to determine if rigorous BP control and RAAS inhibition can slow kidney disease progression in ADPKD.
- Findings will inform clinical practice regarding the management of hypertension and RAAS blockade in ADPKD patients.
- The study will provide valuable insights into preserving kidney function and improving outcomes for individuals with ADPKD.
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