Interventions to Improve Blood Pressure Control Among Socioeconomically Disadvantaged Patients With CKD: Kidney Awareness Registry and Education Pilot Randomized Controlled Trial

RATIONALE mean baseline SBP was 131 (SD = 21.8) mm Hg. Nearly 90% of clinicians reported that the CKD registry influenced their CKD management. More than 95% of patients randomly assigned to CKD self-management support engaged regularly with the intervention. Estimated changes in SBP over 1 year were nonstatistically different in each of the 3 intervention groups compared with usual care: (usual care: 0.5 95% CI, -5.2 to 6.3 mm Hg; CKD registry only: -5.4 95% CI, -12.2 to 1.4 mm Hg; CKD self-management support only: -6.4 95% CI, -13.7 to 1.0 mm Hg; and CKD registry plus CKD self-management support: -0.5 -5.5 to 4.5 mm Hg), though differences were larger among those with baseline SBPs > 140/90 mm Hg. Decreases in albuminuria were similarly nonstatistically different in each of the intervention groups compared with usual care. No differences were observed in patient self-reported behaviors. LIMITATIONS: Single health system. CONCLUSIONS: Patient and provider interventions to improve CKD care are feasible to implement in low-income settings with promising results among those with uncontrolled blood pressure. FUNDING: National Institute of Diabetes and Digestive and Kidney Diseases. TRIAL REGISTRATION: ClinicalTrials.gov, number: NCT01530958.