Dr Priyanka Sagar1,2, Ms Alexandra Munt1,2, Dr Sayanthooran Saravanabavan1,2, Mr James Elhindi3, Ms Beatrice Nguyen1,4, Dr Katrina Chau5,6, Prof David Harris1,2,4, A/Prof Vincent Lee2,4, A/Prof Kamal Sud4,7, Dr Nikki Wong4,7, Prof Gopala Rangan1,2
1Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute For Medical Research, The University of Sydney, Westmead, 2145, 2Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Westmead, 2145, 3Research and Education Network, Westmead Hospital, Western Sydney Local Health District, Westmead, 2145, 4Faculty of Medicine and Health, The University of Sydney, Sydney, 2145, 5Department of Renal Medicine, Blacktown Hospital, Western Sydney Local Health District, Blacktown, 2148, 6Blacktown Clinical School, Western Sydney University,, Blacktown, 2148, 7Department of Renal Medicine, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, 2750
Aim: To evaluate the efficacy of beetroot juice (BRJ) on reducing blood pressure (BP) in hypertensive adults with autosomal dominant polycystic kidney disease (ADPKD).
Background: Impaired endothelial-derived nitric oxide (NO) synthesis due to dysfunction of polycystin-1 is a key contributor to the pathogenesis of hypertension in ADPKD. In previous studies of chronic kidney disease, BRJ increased plasma NO, reduced BP and improved endothelial function.
Methods: In this single-centre, investigator-initiated, randomised, double-blind, placebo-controlled study (Western Sydney Local Health District Human Research Ethics Committee approval 2020_ETH01718), ADPKD patients (n=60; ages 17-80 years, eGFR>30ml/min/1.73m2 and treated with at least one anti-hypertensive drug) will be allocated 1:1 to either 70mls of nitrate-rich (400mg nitrate/dose) or nitrate-depleted BRJ daily for 4 weeks. The primary outcome is change in the clinic BP from baseline. Secondary outcomes are changes in daily home BP, urinary albumin to creatinine ratio, serum NO metabolites and serum asymmetric dimethylarginine from baseline. Adherence will be monitored by responses to daily text messages with home BP values.
Results: Recruitment commenced in May 2022 and participants were identified from a PKD Database and direct communication with nephrologists. To date, 112 participants have been identified and 35 were eligible. Of these, 11 did not respond to invitation, 5 were excluded for other reasons and 19 were recruited. 10 participants have completed screening and 4 have been randomised. Based on the current recruitment rate of 4.5 patients/week, we expect that the trial will be completed in October 2022.
Conclusions: The good recruitment in this study suggests that people with ADPKD may favour participation in short-term clinical trial interventions perceived as having minimal adverse effects and endorsed by their nephrologist.
Biography:
Priyanka is a nephrologist and PhD candidate at the Westmead Institute for Medical Research under the supervision of Prof Gopi Rangan. Her research focuses on experimental and clinical polycystic kidney diseases, with an interest in the impact of hormonal and lifestyle modifications in PKD.