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dc.contributor.authorRoberts, Matthew A
dc.contributor.authorPilmore, Helen L
dc.contributor.authorIerino, Francesco L
dc.contributor.authorBadve, Sunil V
dc.contributor.authorCass, Alan
dc.contributor.authorGarg, Amit X
dc.contributor.authorIsbel, Nicole M
dc.contributor.authorKrum, Henry
dc.contributor.authorPascoe, Elaine M
dc.contributor.authorPerkovic, Vlado
dc.contributor.authorScaria, Anish
dc.contributor.authorTonkin, Andrew M
dc.contributor.authorVergara, Liza A
dc.contributor.authorTan, Ken-Soon
dc.contributor.authoret al.
dc.description.abstractBackground: β-Blocking agents reduce cardiovascular mortality in patients with heart disease, but their potential benefit in dialysis patients is unclear. We aimed to determine the feasibility of a randomized controlled trial (RCT). Study Design: Pilot RCT. Setting & Participants: Patients who received dialysis for 3 or more months and were 50 years or older (or ≥18 years with diabetes or cardiovascular disease) were recruited from 11 sites in Australia and New Zealand. We aimed to recruit 150 participants. Intervention: After a 6-week run-in with the β-blocker carvedilol, we randomly assigned participants to treatment with carvedilol or placebo for 12 months. Outcomes & Measurements: The prespecified primary outcome was the proportion of participants who tolerated carvedilol, 6.25 mg, twice daily during the run-in period. After randomization, we report participant withdrawal and the incidence of intradialytic hypotension (IDH). Results: Of 1,443 patients screened, 354 were eligible, 91 consented, and 72 entered the run-in stage. 49 of 72 run-in participants (68%; 95% CI, 57%-79%) achieved the primary outcome. 5 of the 23 withdrawals from run-in were attributable to bradycardia or hypotension. After randomization, 10 of 26 allocated to carvedilol and 4 of 23 allocated to placebo withdrew. 4 participants randomly assigned to carvedilol withdrew because of bradycardia or hypotension. Overall, there were 4 IDH events per 100 hemodialysis sessions; in participants allocated to carvedilol versus placebo, respectively, there were 7 versus 2 IDH events per 100 hemodialysis sessions (P = 0.1) in the 2 weeks immediately following a dose increase and 4 versus 3 IDH events per 100 hemodialysis sessions after no dose increase (P = 0.7). Limitations: Unable to recruit planned sample size. Conclusions: Recruiting patients receiving dialysis to an RCT of β-blocker versus placebo will prove challenging. Possible solutions include international collaboration and exploring novel trial designs such as a registry-based RCT.
dc.relation.ispartofjournalAmerican Journal of Kidney Diseases
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsUrology & Nephrology
dc.titleThe β-Blocker to Lower Cardiovascular Dialysis Events (BLOCADE) feasibility study: A randomized controlled trial
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationRoberts, MA; Pilmore, HL; Ierino, FL; Badve, SV; Cass, A; Garg, AX; Isbel, NM; Krum, H; Pascoe, EM; Perkovic, V; Scaria, A; Tonkin, AM; Vergara, LA; Tan, KS; et al. The β-Blocker to Lower Cardiovascular Dialysis Events (BLOCADE) feasibility study: A randomized controlled trial, American Journal of Kidney Diseases, 2016, 67 (6), pp. 902-911
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gro.griffith.authorZHANG, LEI

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