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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
PubMed

Insights

Blood pressure control in chronic kidney disease (CKD) is challenging. A self-management intervention involving home 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 but difficult in patients with chronic kidney disease (CKD).
  • Self-management strategies are increasingly important for managing 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 patient willingness to participate in randomized trials for self-management.

Main Methods:

  • A randomized feasibility trial comparing a self-management intervention to standard care.
  • Intervention included monthly home blood pressure monitoring and participant-led therapy adjustments.
  • Feasibility assessed by enrollment, adherence, and data collection; clinical outcomes measured by office BP readings.

Main Results:

  • 58 participants (15% enrollment rate) were randomized; 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 between groups at 6 or 12 months.

Conclusions:

  • The blood pressure self-management intervention is feasible in a secondary care CKD population.
  • Patients were willing to be randomized to this self-management approach.
  • Future trials require protocol amendments, including enhanced support and educational materials.
Abstract

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