CHARLESTON STUDY OF KIDNEY DISEASE IN AFRICAN AMERICANS

65名18-70岁的非裔美国人患有高血压肾病 疾病将随机接受为期4年的治疗，无论是 血管紧张素转换酶抑制剂、钙通道阻滞剂或 作为一线降压药的β-受体阻滞剂，以及两种 控制血压水平以确定：1)是否治疗高血压 延缓肾功能不全的进展；2)三者之一 药物提供了特定的肾脏保护作用；以及3)控制 较低的血压水平在更大程度上保护了肾功能。英国石油将 至少每月监测和调整药物，以监测患者 合规性和不良影响，并确保指定的BP目标是 已实现。肾小球滤过率将按季度测量，因为 [~(125)I]-硫代氨基甲酸盐的血浆消失。受试者将被招募 来自南卡罗来纳医科大学(MUSC)诊所的Fetter 家庭健康诊所，加州卫生署，私人医生， 当地教堂和社区高血压筛查项目。这项研究 将通过电视、广播、报纸、海报在当地进行宣传， 以及给医生的信。鼓励受试者参与和 确保保留和合规，将在现场进行考察访问 对查尔斯顿市中心的目标人群来说很方便，在约翰斯 利用Fetter的诊所设施，在永泽岛上 家庭健康中心以及综合临床研究中心 (GCRC)在南加州大学。将提供交通工具。全职护士 协调员和数据办事员将协调预约和 确保对患者的随访。一位经验丰富的药剂师将协助 药品分发、跟踪和记录。地方临床 已通过GCRC实验室、MUSC安排了实验室支持 临床实验室和Fetter临床实验室。数据收集 并将通过使用GCRC Prophet计算机来促进管理 与NIH和研究使用的PC联网的资源 人事部。

Sixty-five African Americans aged 18-70 years with hypertensive kidney disease will be randomized to treatment for 4 years with either an angiotensin converting enzyme inhibitor, a calcium channel blocker or a beta-blocker as a first line antihypertensive drug, and to one of two levels of BP control to determine: 1) whether treatment of hypertension slows progression of renal insufficiency; 2) whether one of the three drugs offers a specific reno-protective effect; and 3) whether control of BP to a lower level protects renal function to a greater degree. BP will be monitored and medications adjusted at least monthly to monitor patient compliance and adverse effects and to ensure that assigned BP goals are achieved. Glomerular filtration rate will be measured quarterly as the plasma disappearance of [125I]-iothalamate. Subjects will be recruited from clinics at the Medical University of South Carolina (MUSC), Fetter Family Health Clinics, the SC Department of Health, private physicians, local churches, and community hypertension screening programs. The study will be publicized locally using television, radio, newspapers, posters, and letters to physicians. To encourage subject participation and to ensure retention and compliance, study visits will be performed at sites convenient to the target population in downtown Charleston, on Johns Island and on Yonges Island, using the clinic facilities of the Fetter Family Health Centers, as well as the General Clinical Research Center (GCRC) at MUSC. Transportation will be provided. A fulltime nurse coordinator and data clerk will coordinate scheduling of appointments and ensure followup of patients. An experienced pharmacist will assist with medication distribution, tracking, and documentation. Local clinical laboratory backup has been arranged through the GCRC laboratory, the MUSC Clinical Laboratory and the Fetter Clinic Laboratories. Data collection and management will be facilitated by the use of the GCRC Prophet computer resource which is networked to the NIH and to PCs used by the study personnel.