The Home Blood Pressure (BP) Trial (Home-BP)
End Stage Renal Disease on Dialysis
About this trial
This is an interventional treatment trial for End Stage Renal Disease on Dialysis focused on measuring Blood pressure, dialysis
Eligibility Criteria
Inclusion Criteria:
- Aged 18 years or older
- Undergoing in-center, thrice weekly hemodialysis for treatment of end stage renal disease (ESRD)
- Greater than 3 months since initiation of dialysis
- No anticipated change to peritoneal dialysis or kidney transplant within 10 months
- Life expectancy greater than 10 months
- Hypertension (defined as mean pre-dialysis SBP > 140 mmHg over prior 2 weeks or taking BP medications)
- Able to obtain/measure a brachial blood pressure at dialysis and at home (e.g., no left ventricular assist device, blood pressure not been taken routinely in lower extremity at dialysis unit)
- No condition that the primary nephrologist or PIs feel precludes participation
Exclusion Criteria:
- Incarcerated or institutionalized (prohibits home blood pressure measurement)
- Participating in another intervention study that may affect blood pressure
- Pregnant or anticipated pregnancy or breastfeeding (as this will require increase to more than three times a week dialysis and/or preclude use of some classes of blood pressure medications)
Sites / Locations
- University of California San FranciscoRecruiting
- University of WashingtonRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Other
Home Systolic Blood Pressure <140 mmHg
Pre-Dialysis Systolic Blood Pressure <140 mmHg
Home Systolic Blood Pressure <130 mmHg
Participants will take their home blood pressure two times per week (one in the morning and one in the evening) on non-dialysis days, ideally mid-week. Home blood pressures will be reviewed every two weeks and dry weight and medications adjusted accordingly to reach a home systolic blood pressure target of <140 mmHg.
Participants will have their blood pressure taken by an automated blood pressure device by dialysis unit staff using regular dialysis unit equipment according to usual clinical care. Pre-dialysis blood pressures will be reviewed every two weeks and dry weight and medications adjusted accordingly to reach a pre-dialysis systolic blood pressure target of <140 mmHg.
This will be an optional, exploratory 2 month study at the end of the primary 10-month trial. Participants will take their home blood pressure two times per week (one in the morning and one in the evening) on non-dialysis days, ideally mid-week. Home blood pressures will be reviewed every two weeks and dry weight and medications adjusted accordingly to reach a home systolic blood pressure target of <130 mmHg.