Diuretic Testing in Chronic Kidney Disease

Inclusion criteria

for CKD subjects:

• CKD stage G3 (creatinine-based eGFR 30-59 mL/min/1.73m2) during the last outpatient visit

Inclusion criteria

for Healthy subjects:

• eGFR within the expected range for age (a decline of 1 ml/min/1.73 m2 per year starting from age 40 is considered the normal age-related decline in kidney function

Exclusion criteria

• Known intolerance or allergy to the diuretics
• Current systemic chemotherapy for malignancy
• Kidney transplant recipient
• Use of calcineurin-inhibitors
• Life expectancy < 12 months
• Current immunosuppressive treatment for glomerulonephritis
• Incapacitated subjects or subjects who are deemed unfit to adequately adhere to instructions from the research team
• Hypokalemia or hyperkalemia (K+ < 3.0mmol/L or K+ > 5.5 mmol/L) at inclusion visit
• Hypo- or hypernatremia (Na+ < 130 mmol/L or Na+ > 150mmol/L) at inclusion visit
• Inherited tubulopathy as the cause of CKD
• Autosomal dominant polycystic or tubulointerstitial kidney disease causing CKD
• Clinically relevant heart failure (New York Heart Association class III or IV)
• Therapy-resistant hypertension, defined as systolic blood pressure > 180mmHg at the inclusion visit
• Current treatment with inhibitors of Organic anion transporters: probenecid, pravastatin, cimetidine, cephalosporins, acetazolamide [22]
• Active hepatitis during last outpatient visit
• Liver cirrhosis in advanced stage (Child-Pugh B or C)
• Active drug- or alcohol abuse
• Not being able to tolerate a 28-day washout of one of the drugs interfering with diuretic testing.
• Women who are pregnant, breastfeeding, or planning on becoming pregnant before the test day