Aliskiren and Muscle Sympathetic Nerve Activity

Study Overview
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Brief Summary
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The central hypothesis of this project is that Aliskiren causes a substantial decrease in MSNA in hypertensive patients with CKD.

Detailed Description
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Cardiovascular (CV) morbidity and mortality are frequently occurring problems in chronic kidney disease (CKD) patients. Apart from the so called traditional risk factors, also risk factors more or less specific to CKD contribute in the pathogenesis of these problems. There is strong evidence that the sympathetic hyperactivity, which often characterizes CKD, is one such factor. Previously, we have shown that angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) reduce but not normalize this sympathetic hyperactivity. We re-analysed the cohort of patients who were investigated in the past and subsequently treated according to present guidelines. The results show that, despite of treatment, the unfavourable relation between sympathetic hyperactivity and clinical outcome still exits. This might mean that treatment is insufficient. In present study, we want to study the effect of Aliskiren 300mg on sympathetic nerve activity.

Official Title
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Effect of Aliskiren on Muscle Sympathetic Nerve Activity (MSNA) in Hypertensive Patients With Chronic Kidney Disease

Conditions
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Chronic Kidney Disease, Hypertension, Muscle Sympathetic Nerve Activity

Intervention / Treatment
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* Drug: Aliskiren


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with stable chronic kidney disease and hypertension: i.e. using antihypertensive drugs and/or blood pressure > 145/90 mmHg when off medication. Patients on ACE inhibitor or ARB Exclusion Criteria: Patients with diabetes mellitus Patients on renal replacement therapy Pregnant patients Using of antihypertensive which cannot be stopped Patients on immunosuppressive therapy and active nephrotic syndrome

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 95 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group 1<br>Patients receive Aliskiren 300mg for 6 weeks | Drug: Aliskiren<br>* Aliskiren 300mg per day for 6 weeks<br>* Other names: Rasilez 300mg per day;|
| No Intervention: Group 2<br>4 weeks no antihypertensive medication | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Normalisation of muscle sympathetic nerve activity |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood pressure and Blood tests |  | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Renin inhibitor, Patients, ACE inhibitor or ARB, Chronic Kidney Disease, Hypertension