Evidence map›Paper›PMID 25680887›Full record

Trial reportClinical and experimental nephrology2015

Prospective randomized study of the tolerability and efficacy of combination therapy for hypertensive chronic kidney disease: results of the PROTECT-CKD study.

Matsuhiko Hayashi, Shunya Uchida, Tetsuya Kawamura, Michio Kuwahara, Masaomi Nangaku, Yasuhiko Iino, PROTECT-CKD Study Group

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical and experimental nephrology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Framework of Guidelines for Management of CKD in Asia.Kidney international reports · 2024
    Article
  5. Observational
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Matsuhiko HayashiApheresis and Dialysis Center, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. matuhiko@z3.keio.jp.
Shunya UchidaSchool of Medicine, Teikyo University, Tokyo, Japan.
Tetsuya KawamuraSchool of Medicine, The Jikei University, Tokyo, Japan.
Michio KuwaharaShuwa General Hospital, Kasukabe, Japan.
Masaomi NangakuSchool of Medicine, The University of Tokyo, Tokyo, Japan.
Yasuhiko IinoNippon Medical School, Tokyo, Japan.
PROTECT-CKD Study Group
Jikei University School of Medicine · JPKeio University · JPThe University of Tokyo · JPNippon Medical School · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe conducted a randomized, open-label trial to determine which of the antihypertensive drugs was most beneficial for CKD patients with hypertension in spite of treatment with an angiotensin receptor blocker (ARB).

methodsPatients 20-75 years of age who had CKD according to the definition in the K/DOQI Guidelines and hypertension (systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥80 mmHg) with the usual dose of an ARB were randomly assigned to receive losartan 50 mg plus 5 mg of the calcium channel blocker amlodipine (CCB group, n = 37), 5 mg of the angiotensin-converting enzyme inhibitor enalapril (ACEI group, n = 36), or 12.5 mg of the thiazide diuretic hydrochlorothiazide (HCTZ group, n = 36). The primary endpoints were changes in blood pressure (BP), ratio of urinary excretion of protein to creatinine (UPCR), tolerability, and eGFR during the 12-month treatment period compared with control period.

resultsThere were no significant differences in BP and tolerability between the three groups. The percentage changes in UPCR at 12 months after start of the combination therapy were significantly different in the HCTZ group (-26.3 ± 11.1 %, mean ± SE) and CCB group (+46.7 ± 33.6 %, p < 0.05), while eGFR was significantly lower in the HCTZ group than in the ACEI group or CCB group at 4 months but not at 12 months.

conclusionAddition of diuretics, CCB, or ACEI to ARB was equally effective for the control of hypertension in CKD, while, in terms of urinary excretion of protein, diuretics may be better than CCB.

Indexed as

AdultAgedAmlodipineAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersAntihypertensive AgentsBlood PressureCalcium Channel BlockersDiureticsDrug Therapy, CombinationEnalaprilFemaleHumansHydrochlorothiazideHypertension, RenalLosartanAmlodipineAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersAntihypertensive AgentsCalcium Channel BlockersDiureticsEnalaprilHydrochlorothiazideLosartanAngiotensin-converting enzyme inhibitorAngiotensin receptor blockerCalcium channel blockerChronic kidney diseaseDiuretics

Identifiers

PMID25680887
OpenAlexW2083165684

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.