Rapid and Simultaneous Initiation of Four Guideline-Directed CKD Therapies (RAPID-CKD)

Summary

The goal of this clinical trial is to learn if starting four kidney disease medicines quickly and together (a rapid treatment approach) is safe and works well in people with type 2 diabetes and chronic kidney disease.

The main questions it aims to answer are:

* Is it safe to start these medicines over a short period of time?
* How often do kidney function changes or high potassium levels occur?
* Does this approach lower protein in the urine (a sign of kidney damage)?
* How many participants are able to stay on all four medicines over 6 months?

Researchers will compare this approach to usual care, where medicines are started one at a time over several months.

Participants will:

Be assigned by chance to either this approach or usual care Start up to four approved kidney medicines over about 8 weeks (rapid treatment approach) or follow standard care Have regular clinic visits and lab tests to check kidney function and potassium levels Be followed for about 6 months

Conditions

• Chronic Kidney Disease
• Type 2 Diabetes

Interventions

DRUG

Finerenone

10-40mg daily

DRUG

Semaglutide

.25-1.0mg 1 time a week

DRUG

Lotensin

10-40mg daily

DRUG

Capoten

12.5-50mg 3 times a day

DRUG

Enalapril

2.5-10mg daily

DRUG

Monopril

10-40mg daily

DRUG

Lisinopril

5-20mg daily

DRUG

Univasc

3.75-15mg daily

DRUG

Aceon

4-16mg daily

DRUG

Accupril

10-40mg daily

DRUG

Altace

1.25-5mg daily

DRUG

Mavik

1-4mg daily

DRUG

Edarbi

40-80mg daily

DRUG

Atacand

8-32mg daily

DRUG

Avapro

150-300mg daily

DRUG

Cozaar

25-100mg daily

DRUG

Benicar

20-40mg daily

DRUG

Micardis

20-80mg daily

DRUG

Diovan

80-320mg daily

DRUG

Invokana

100mg daily

DRUG

Farxiga

10mg daily

DRUG

Jardiance

10mg daily

DRUG

Ertugliflozin

5mg daily

DRUG

Brenzavvy

20mg daily

DRUG

Sotagliflozin

200-400mg daily

Sponsors & Collaborators

• Baylor Research Institute

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

84 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-04-30

Primary Completion

2029-03-31

Completion

2029-03-31

FDA Drug

Yes

Countries

• United States

Study Locations