Agarwal R, Sinha AD, Cramer AE, et al. - Improvement in blood-pressure control at 12 weeks is conferred by chlorthalidone therapy, vs placebo, in patients with advanced chronic kidney disease and poorly controlled hypertension.

• A total of 160 patients with stage 4 chronic kidney disease and poorly controlled hypertension were randomized to receive chlorthalidone or placebo; randomization was stratified based on previous use of loop diuretics.

• In the chlorthalidone and placebo groups, the adjusted change in 24-hour systolic blood pressure from baseline to 12 weeks was −11.0 mm Hg and −0.5 mm Hg, respectively.

• The between-group difference was −10.5 mm Hg (P<0.001).

• From baseline to 12 weeks, the % change in the urinary albumin-to-creatinine ratio was lower in the chlorthalidone group than in the placebo group by 50 percentage points.

• The chlorthalidone group showed more frequent occurrence of hypokalemia, reversible rises in serum creatinine level, hyperglycemia, dizziness, and hyperuricemia, vs the placebo group.