Chlorthalidone in Advanced Chronic Kidney Disease — Have We Missed a Trick?

The editorial discusses the potential benefits of chlorthalidone in managing hypertension in advanced chronic kidney disease (CKD), based on findings from the CLICK trial. The trial demonstrated significant reductions in 24-hour ambulatory systolic blood pressure (−11.0 mm Hg) with chlorthalidone compared to placebo (−0.5 mm Hg) in patients with stage 4 CKD. Secondary outcomes included a 50% lower urinary albumin-to-creatinine ratio, suggesting possible kidney protection. Adverse effects like hypokalemia and reversible eGFR decline were noted. The author highlights the need for larger, longer-term trials to confirm cardiorenal benefits and safety.

The editorial discusses the potential benefits of chlorthalidone in managing hypertension in advanced chronic kidney disease (CKD), based on findings from the CLICK trial. The trial demonstrated significant reductions in 24-hour ambulatory systolic blood pressure (−11.0 mm Hg) with chlorthalidone compared to placebo (−0.5 mm Hg) in patients with stage 4 CKD. Secondary outcomes included a 50% lower urinary albumin-to-creatinine ratio, suggesting possible kidney protection. Adverse effects like hypokalemia and reversible eGFR decline were noted. The author highlights the need for larger, longer-term trials to confirm cardiorenal benefits and safety.