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A Self-Management Approach to Managing Hypertension Associated with CKD: A Feasibility Randomized Trial
Bethany J Lucas1,2, Ashveer S Randhay1,2, Kelly White1
1Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, United Kingdom.
Kidney360
|July 27, 2026
Summary
Blood pressure control in chronic kidney disease (CKD) is challenging. A self-management intervention involving home blood pressure monitoring was feasible in CKD patients, though larger trials are needed.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Health Services Research
Background:
- Blood pressure control is critical yet difficult in patients with chronic kidney disease (CKD).
- Self-management strategies are increasingly explored to improve outcomes in CKD.
- The Self-Management and Realisation of Target BP in CKD (SMaRT BP CKD) trial evaluated a novel intervention.
Purpose of the Study:
- To assess the feasibility of a blood pressure self-management intervention in CKD patients.
- To evaluate the trial design for future larger studies.
- To determine participant willingness to engage in randomized trials for self-management.
Main Methods:
- A randomized feasibility trial was conducted in nephrology clinics.
- Participants were assigned to standard care or an intervention group.
- The intervention included monthly home blood pressure monitoring and participant-led therapy adjustments.
Main Results:
- Enrollment was 15% (58/390 invited); 90% completed 12 months follow-up.
- Intervention group showed more treatment escalations (p=0.04) but also more discontinuations.
- No significant differences in systolic blood pressure at 6 or 12 months between groups.
Conclusions:
- The blood pressure self-management intervention is feasible in a secondary care CKD population.
- Participants were willing to be randomized to this self-management approach.
- Future trials require protocol amendments, including enhanced support and educational materials.
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