SPIRO-CKD Trial

SPIRO-CKD Trial

The SPIRO-CKD Trial is funded by a £960,000 grant from the British Heart Foundation. It is based in 4 UK centres: Birmingham, Cambridge, Edinburgh and University College London. The chief investigator is Professor Jon Townend, Professor of Cardiology at the University of Birmingham. The Edinburgh lead is Professor David Webb, Professor of Therapeutics at the University of Edinburgh, and Director of Edinburgh’s European Society of Hypertension Excellence Centre.

Background

About 1 in 10 people in the UK have mild chronic kidney disease (CKD). Patients with CKD are at increased risk of high blood pressure, thickening of the heart muscle, and stiffness of the blood vessels, which can lead to heart disease and strokes. Spironolactone is a drug, which has been used to treat patients with high blood pressure and heart disease for a long time. In a small trial of patients with mild kidney disease, spironolactone seems to improve heart structure and function, and reduce stiffening of the blood vessels.

The SPIRO-CKD trial aims to find out whether spironolactone acts in a unique way to improve heart and blood vessel structure and function or whether these effects are simply due to lowering of blood pressure, which has benefits of its own.

Study Design

SPIRO-CKD aims to recruit 300 patients between the four centres. Half of those recruited will be treated with spironolactone and half with another blood pressure lowering medication called chlortalidone (chlortalidone is a standard drug to treat blood pressure but works in a different way to spironolactone). The study medication will be taken once daily for a total of 40 weeks. At the beginning of the study participants will undergo certain baseline tests, including blood and urine tests, 24 hour blood pressure monitoring, measurements or arterial stiffness and MRI heart scanning to give a detailed picture of the heart and arteries. The same tests will be repeated after 40 weeks to see what changes there have been following treatment with either spironolactone or chlortalidone. Over the course of the study, there will be follow-up study visits to the hospital at intervals to do routine blood tests.

Flow chart describing SPIRO-CKD Trial

SPIRO-CKD in Edinburgh

Recruitment began in Edinburgh in summer 2014. We aim to recruit around 75 patients to the study over a 3-year period. The study will be recruiting from hospital, through renal and hypertension clinics, and from general practice, with help from the Scottish Primary Care Research Network (SPCRN).

Further information

If you would like to receive further information regarding the study or are interested in taking part, please contact Ms Vanessa Melville, Clinical Research Centre, Western General Hospital, Edinburgh. Tel. 0131 537 2008. Email v.melville@ed.ac.uk.

Funding

The SPIRO-CKD Trial is funded by the British Heart Foundation.

British Heart Foundation The University of Edinburgh NHS Lothian University of Birmingham University of Cambridge UCL