{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:59:09Z","timestamp":1785171549037,"version":"3.55.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite its importance, blood pressure control in CKD remains challenging, prompting a focus on self-management approaches. We conducted a randomised feasibility trial of a blood pressure self-management intervention in persons with CKD: the Self-Management and Realisation of Target BP in CKD (SMaRT BP CKD) trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eligible participants were recruited from nephrology clinics and randomised to standard care or intervention. The intervention comprised of monthly home blood pressure monitoring and participant-led assessment and escalation of therapy based on pre-agreed plan. Standardised office blood pressure readings were taken at baseline, 6 and 12 months. Primary outcomes assessed feasibility of the intervention and trial design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 390 persons invited, 58 (15%) were enrolled; 23 participants in the intervention and 29 in standard care group completed 12 months of follow up (90%). Median (IQR) baseline systolic blood pressure for the cohort was 143 (135-154)mmHg and diastolic blood pressure 79 (70-89)mmHg. Median eGFR for the cohort was 32 (28-53)ml\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      and urine ACR 220.4 (47.8-731) mg\/g. The median number of home readings in the intervention group was 41 (28-42) of an expected 42 (98%) in months 0-6 and 35 (19-42) (83%) in months 6-12. There were more treatment escalations in the intervention group, median 2 (0-3) versus 1 (0-1.5) in standard care (p=0.04). However, there were also more anti-hypertensives discontinued in the intervention group. At six months there was a non-significant -5.8 (-14.4 to 2.6)mmHg difference in systolic blood pressure between groups (p=0.18) and at twelve months this was 3.9 (-4.7 to 12.5)mmHg (p=0.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Participants were willing to be randomised to a self-management blood pressure intervention and the intervention was feasible in a secondary care CKD population. The results of this trial have highlighted potential protocol amendments for a future larger, trial including additional targeted educational material and enhanced research team support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000001316","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:00:29Z","timestamp":1785168029000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Self-Management Approach to Managing Hypertension Associated with CKD"],"prefix":"10.34067","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-6252","authenticated-orcid":false,"given":"Bethany J.","family":"Lucas","sequence":"first","affiliation":[{"name":"Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, United Kingdom"},{"name":"Department of Renal Medicine, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1434-3456","authenticated-orcid":false,"given":"Ashveer S.","family":"Randhay","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, United Kingdom"},{"name":"Department of Renal Medicine, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"White","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0351-8326","authenticated-orcid":false,"given":"Nicholas M.","family":"Selby","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, United Kingdom"},{"name":"Department of Renal Medicine, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9065-212X","authenticated-orcid":false,"given":"Maarten W.","family":"Taal","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, United Kingdom"},{"name":"Department of Renal Medicine, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,27]]},"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.34067\/KID.0000001316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:00:29Z","timestamp":1785168029000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.34067\/KID.0000001316"}},"subtitle":["A Feasibility Randomized Trial"],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":0,"URL":"https:\/\/doi.org\/10.34067\/kid.0000001316","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]},"assertion":[{"value":"2026-01-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}