Skip to main content
Français National
Donate Now

CENTRAL-CKD

Dr. Rémi Goupil
CIUSSS du Nord-de-l'Ile-Montréal
Kidney Health Research Grant
2021 - 2023
$100,000
Hypertension

General Audience Summary

Purpose: In patients with the most severe form of chronic kidney disease, blood pressure (BP) control can be difficult as the margin of error between a too low BP and a too high BP is quite thin. Keeping the BP in the appropriate range helps minimise the risk of progression towards dialysis and the risk of cardiovascular complications. Also, it helps reduce side effects of medication and symptoms related to inappropriate BP. However, the way we currently measure BP, with a cuff installed on the upper arm (or brachial BP), can be highly inaccurate to determine the BP that is in the large vessels in the body (or aortic BP). It is important to have the best estimation of this last BP as it is the one that directly impact the heart, the brain and the kidneys. These past years, central BP devices have been developed and we can now have a better estimation of the aortic BP. We think that better estimating aortic BP with central BP devices instead of using brachial BP values will allow us to improve the life of people with severe kidney disease.

Procedure: This study will assign at random 116 patients with severe kidney disease to a central BP target or to a brachial BP target. These two BP will be measured at the same time by one machine. The patients, doctors and investigators will not know what target was allocated (blinded trial). During the study, the patients will be taken care of as usual by their kidney doctors who will not know if the BP that is provided is a central or a brachial BP.

Outcome: This study aims to determine the feasibility of doing a larger trial aimed at verifying which strategy is best for outcomes that are more important to patients, but also to determine which strategy results in the lower arterial stiffness after 12 months, as a marker of cardiovascular disease.

Relevance to patients: The CENTRAL-CKD study has the potential to change how we treat high blood pressure in patients with severe kidney disease, in an attempt to reduce the burden associated with this condition.