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In advanced CKD with poorly controlled hypertension, chlorthalidone reduced BP at 12 wk
1Johns Hopkins University, Baltimore, Maryland, USA (D.C.C.).
Annals of Internal Medicine
|February 28, 2022
Insights
Chlorthalidone effectively lowers blood pressure in patients with advanced chronic kidney disease. This finding is crucial for managing hypertension in this high-risk population.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Hypertension is a common and serious complication in patients with advanced chronic kidney disease (CKD).
- Thiazide-type diuretics are recommended for hypertension but their efficacy in advanced CKD is uncertain.
- Chlorthalidone is a potent thiazide-type diuretic.
Purpose of the Study:
- To evaluate the efficacy and safety of chlorthalidone for hypertension management in patients with advanced chronic kidney disease.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- Participants with advanced CKD (estimated glomerular filtration rate <30 mL/min/1.73 m²) and hypertension were enrolled.
- Patients received either chlorthalidone or a placebo, with dose adjustments to achieve target blood pressure.
Main Results:
- Chlorthalidone significantly reduced systolic blood pressure compared to placebo.
- The reduction in blood pressure was consistent across different levels of kidney function.
- Adverse events were similar between the chlorthalidone and placebo groups.
Conclusions:
- Chlorthalidone is an effective and safe option for treating hypertension in patients with advanced chronic kidney disease.
- This study supports the use of chlorthalidone in this population, potentially improving cardiovascular outcomes.
Abstract
Source Citation:
Agarwal R, Sinha AD, Cramer AE, et al. Chlorthalidone for hypertension in advanced chronic kidney disease. N Engl J Med. 2021;385:2507-19. 34739197.
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