Effect of the combination of bumetanide plus chlorthalidone on hypertension and volume overload in patients with chronic kidney disease stage 4-5 KDIGO without renal replacement therapy: a double-blind randomized HEBE-CKD trial.
BMC Nephrol
; 23(1): 316, 2022 09 20.
Article
em En
| MEDLINE
| ID: mdl-36127661
ABSTRACT
BACKGROUND:
The co-administration of loop diuretics with thiazide diuretics is a therapeutic strategy in patients with hypertension and volume overload. The aim of this study was to assess the efficacy and safety of treatment with bumetanide plus chlorthalidone in patients with chronic kidney disease (CKD) stage 4-5 KDIGO.METHODS:
A double-blind randomized study was conducted. Patients were randomized into two groups bumetanide plus chlorthalidone group (intervention) and the bumetanide plus placebo group (control) to evaluate differences in TBW, ECW and ECW/TBW between baseline and 30 Days of follow-up. Volume overload was defined as 'bioelectrical impedance analysis as fluid volume above the 90th percentile of a presumed healthy reference population. The study's registration number was NCT03923933.RESULTS:
Thirty-two patients with a mean age of 57.2 ± 9.34 years and a median estimated glomerular filtration rate (eGFR) of 16.7 ml/min/1.73 m2 (2.2-29) were included. There was decreased volume overload in the liters of total body water (TBW) on Day 7 (intervention -2.5 vs. control -0.59, p = 0.003) and Day 30 (intervention -5.3 vs. control -0.07, p = 0.016); and in liters of extracellular water (ECW) on Day 7 (intervention -1.58 vs. control -0.43, p < 0.001) and Day 30 (intervention -3.05 vs. control -0.15, p < 0.000). There was also a decrease in systolic blood pressure on Day 7 (intervention -18 vs. control -7.5, p = 0.073) and Day 30 (intervention -26.1 vs. control -10, p = 0.028) and in diastolic blood pressure on Day 7 (intervention -8.5 vs. control -2.25, p = 0.059) and Day 30 (intervention -13.5 vs. control -3.4, p = 0.018).CONCLUSION:
In CKD stage 4-5 KDIGO without renal replacement therapy, bumetanide in combination with chlorthalidone is more effective in treating volume overload and hypertension than bumetanide with placebo.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Desequilíbrio Hidroeletrolítico
/
Insuficiência Renal Crônica
/
Hipertensão
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
BMC Nephrol
Assunto da revista:
NEFROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
México