Intensification of blood pressure lowering therapeutics based on diuretics versus usual management for uncontrolled hypertension in patients with moderate to severe chronic kidney disease (THINK): protocol for an open label, two-parallel group, cluster ra

Fiche publication

Date publication

septembre 2026

Journal

BMJ open

Auteurs

Membres identifiés du Cancéropôle Est :
Pr ROSSIGNOL Patrick

Tous les auteurs :
Le Vilain-Abraham F, Halimi JM, Rossignol P, Laville M, Azizi M, Stengel B, Maisons V, Rouzès A, Caille A, Sautenet B

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/42754276

Résumé

Hypertension is the primary modifiable risk factor for cardiorenal complications of chronic kidney disease (CKD). It is well established that lowering blood pressure (BP) in patients with CKD reduces renal and cardiovascular complications. The guidelines advise starting the BP-lowering drug with ACE inhibitors (ACEi) or angiotensin receptor blockers (ARB), but then there is no strong evidence to support the preferential use of any particular agent in controlling BP. Our hypothesis is that patients with CKD and uncontrolled hypertension are fluid overloaded and that the second line of treatment after an ACEi or an ARB should be a diuretic.