Evidence map›Paper›PMID 32663820›Full record

ArticleAmerican journal of nephrology2020

Design and Baseline Characteristics of the Chlorthalidone in Chronic Kidney Disease (CLICK) Trial.

Rajiv Agarwal, Andrew E Cramer, Mary Balmes-Fenwick, Arjun D Sinha, Fangqian Ouyang, Wanzhu Tu

Open access · greenAbstract readClinical Trial Protocol
In one paragraph

Article in American journal of nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 17% 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

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Diuretics in patients with chronic kidney disease.Nature reviews. Nephrology · 2025
    Review
  3. New Aspects in the Management of Hypertension in Patients with Chronic Kidney Disease not on Renal Replacement Therapy.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2022
    Review
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

6 authors at 2 institutions in 1 country.

Rajiv AgarwalDivision of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA, ragarwal@iu.edu.
Andrew E CramerDivision of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.
Mary Balmes-FenwickDivision of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.
Arjun D SinhaDivision of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.
Fangqian OuyangDepartment of Biostatistics, Richard M. Fairbanks School of Public Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Wanzhu TuDepartment of Biostatistics, Richard M. Fairbanks School of Public Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Indiana University School of MedicineRichard L. Roudebush VA Medical Center · US

Funding

ChLorthalidone In Chronic Kidney Disease (CLICK) StudyR01HL126903 · NHLBI · INDIANA UNIVERSITY INDIANAPOLIS · PI AGARWAL, RAJIV · 2016 to 2020
$3.2M
NHLBI NIH HHS R01 HL126903
6 · The paper itself

Abstract

backgroundHypertension often accompanies chronic kidney disease (CKD), and diuretics are widely prescribed to reduce blood pressure (BP). Chlorthalidone (CTD) is a thiazide-like diuretic and an effective antihypertensive drug, yet little data exist to support its use in treating hypertension in individuals with advanced CKD.

methodsChlorthalidone in Chronic Kidney Disease (CLICK) is a phase II, single-institution, multicenter, double-blind randomized control trial to test the hypothesis that CTD improves BP, through reduction of extracellular fluid volume, and results in target organ protection in patients with stage 4 CKD and poorly controlled hypertension. After a single-blind placebo run-in for 2 weeks and confirmation of hypertension by 24-h ambulatory blood pressure (ABP), patients are randomized to either placebo or CTD 12.5 mg once daily (QD) followed by dose escalation. Randomization is stratified by prior loop diuretic use, and the double-blind phase lasts 12 weeks. With a total of 160 patients, the study will have ≥80% power to detect a 6 mm Hg difference in systolic 24-h ABP between the 2 treatment groups.

resultsBetween June 2016 and October 2019, 131 patients have been randomized. The baseline characteristics are as follows: average age 65.8 years, 79% men, 36% Black, 79% with diabetes, mean eGFR 23.2 mL/min/1.73 m2, median urine albumin/creatinine ratio 923 mg/g, average number of BP medications 3.4, 60% on loop diuretics, and 24-h ABP averaged 141.7/73.8 mm Hg.

conclusionAmong patients with stage 4 CKD and uncontrolled hypertension, CLICK should answer the question whether CTD is safe and effective.

Indexed as

Antihypertensive AgentsChlorthalidoneDiureticsHypertensionRenal Insufficiency, ChronicAgedBlood PressureBlood Pressure Monitoring, AmbulatoryClinical Trials, Phase II as TopicDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleFemaleHumansMaleMiddle AgedAntihypertensive AgentsChlorthalidoneDiureticsAmbulatory blood pressure monitoringChronic kidney diseaseHypertensionThiazide diuretics

Identifiers

PMID32663820
PMCPMC7409874
OpenAlexW3042462394

What OpenQuestion holds

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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.