Rapid and Simultaneous Initiation of Four Guideline-Directed CKD Therapies (RAPID-CKD)
Summary
The goal of this clinical trial is to learn if starting four kidney disease medicines quickly and together (a rapid treatment approach) is safe and works well in people with type 2 diabetes and chronic kidney disease. The main questions it aims to answer are: * Is it safe to start these medicines over a short period of time? * How often do kidney function changes or high potassium levels occur? * Does this approach lower protein in the urine (a sign of kidney damage)? * How many participants are able to stay on all four medicines over 6 months? Researchers will compare this approach to usual care, where medicines are started one at a time over several months. Participants will: Be assigned by chance to either this approach or usual care Start up to four approved kidney medicines over about 8 weeks (rapid treatment approach) or follow standard care Have regular clinic visits and lab tests to check kidney function and potassium levels Be followed for about 6 months
Timeline
- Start
- 2026-04-30
- Primary completion
- 2029-03-31
- Completion
- 2029-03-31
Publications
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Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Comparator | Aceon | Unknown | 4 mg | — |
| Comparator | Aceon | Unknown | 16 mg | — |
| Comparator | Azilsartan medoxomil | Other / unclassified | 40 mg | — |
| Comparator | Azilsartan medoxomil | Other / unclassified | 80 mg | — |
| Comparator | Benazepril | Unknown | 10 mg | — |
| Comparator | Benazepril | Unknown | 40 mg | — |
| Comparator | Bexagliflozin | Small molecule | 20 mg | — |
| Comparator | CANAGLIFLOZIN ANHYDROUS | Small molecule | 100 mg | — |
| Comparator | Candesartan cilexetil | Unknown | 8 mg | — |
| Comparator | Candesartan cilexetil | Unknown | 32 mg | — |
| Comparator | Captopril | Small molecule | 12.5 mg | — |
| Comparator | Captopril | Small molecule | 50 mg | — |
| Comparator | Empagliflozin | Small molecule | 10 mg | — |
| Comparator | Enalapril | Other / unclassified | 2.5 mg | — |
| Comparator | Enalapril | Other / unclassified | 10 mg | — |
| Comparator | Ertugliflozin | Unknown | 5 mg | — |
| Comparator | Finerenone | Small molecule | 10 mg | — |
| Comparator | Finerenone | Small molecule | 40 mg | — |
| Comparator | Forxiga | Unknown | 10 mg | — |
| Comparator | Fosinopril | Small molecule | 10 mg | — |
| Comparator | Fosinopril | Small molecule | 40 mg | — |
| Comparator | Irbesartan | Small molecule | 150 mg | — |
| Comparator | Irbesartan | Small molecule | 300 mg | — |
| Comparator | LISINOPRIL ANHYDROUS | Small molecule | 5 mg | — |
| Comparator | LISINOPRIL ANHYDROUS | Small molecule | 20 mg | — |
| Comparator | Losartan | Other / unclassified | 25 mg | — |
| Comparator | Losartan | Other / unclassified | 100 mg | — |
| Comparator | Moexipril | Small molecule | 3.75 mg | — |
| Comparator | Moexipril | Small molecule | 15 mg | — |
| Comparator | Olmesartan medoxomil | Unknown | 20 mg | — |
| Comparator | Olmesartan medoxomil | Unknown | 40 mg | — |
| Comparator | Quinapril | Small molecule | 10 mg | — |
| Comparator | Quinapril | Small molecule | 40 mg | — |
| Comparator | Ramipril | Small molecule | 1.25 mg | — |
| Comparator | Ramipril | Small molecule | 5 mg | — |
| Comparator | Semaglutide | Peptide | 0.25 mg | — |
| Comparator | Semaglutide | Peptide | 1 mg | — |
| Comparator | Sotagliflozin | Small molecule | 200 mg | — |
| Comparator | Sotagliflozin | Small molecule | 400 mg | — |
| Comparator | Telmisartan | Other / unclassified | 20 mg | — |
| Comparator | Telmisartan | Other / unclassified | 80 mg | — |
| Comparator | Valsartan | Small molecule | 80 mg | — |
| Comparator | Valsartan | Small molecule | 320 mg | — |
| Comparator | trandolapril | Small molecule | 1 mg | — |
| Comparator | trandolapril | Small molecule | 4 mg | — |