Training community doctors to manage chronic kidney disease using guidelines
Tests guideline training for community doctors treating adults with kidney disease.
Plain-language title generated from the registry record
Registry title: Guideline-diRected MAnagement for Chronic Kidney Disease: EValuation of an Education Progamme in a National Cluster Randomized Controlled Trial
Key facts
- Where
- Guangzhou, ChinaSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with chronic kidney disease. It tests whether training community healthcare providers on guideline-based care improves heart and kidney outcomes.
- Age
- 18 years or older
- Sex
- All sexes can join.
- Disease stage
- Chronic kidney disease: eGFR <60 ml/min/1.73 m² or UACR >30 mg/g on two occasions at least 3 months apart. End-stage disease (eGFR <15 ml/min/1.73 m²) is not included.
- Earlier treatment
- People already on regular dialysis or who have had a kidney transplant cannot join.
- Biomarker or test result
- eGFR <60 ml/min/1.73 m² or UACR >30 mg/g, measured on two occasions at least 3 months apart.
Main reasons for not taking part
- Under 18 years old
- End-stage kidney disease (eGFR <15 ml/min/1.73 m²)
- Already on regular dialysis or had a kidney transplant
- Pregnant or breastfeeding women
- Taking part in another clinical trial
Read by machine on 9 November 2026.
Where in China
- Guangdong Provincial People's HospitalGuangzhou, ChinaNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Guangdong Provincial People's Hospital
- Trial code
- NCT06825676
- Record updated
- 13 February 2025
- Original description
Study Objective:Read full original descriptionShow less
Guideline-diRected MAnagement for Chronic Kidney Disease: EValuation of an Education Progamme in a National Cluster Randomized Controlled Trial (GRAVER)
Study Objective:
To evaluate the impact of guideline-based CKD comprehensive management medical re-education for community healthcare providers on improving cardio-renal outcomes in CKD patients.
Study Design:
A nationwide, multicenter, prospective, cluster-randomized controlled trial.
Inclusion and Exclusion Criteria:
Inclusion Criteria: Chronic kidney disease (CKD) patients meeting the following criteria:
eGFR <60 mL/min/1.73 m² or UACR >30 mg/g on two separate occasions at least 3 months apart.
Exclusion Criteria:
Age <18 years. End-stage renal disease (ESRD) with eGFR <15 mL/min/1.73 m², or patients already on regular dialysis or having received a kidney transplant.
Pregnant or breastfeeding women. Patients participating in any other clinical trials. Patients who exhibit characteristics at the screening stage that suggest they are unable to complete the study.
Intervention:
Control Group: Routine community training and management. Intervention Group: Training for community healthcare providers on guideline-based CKD management, including lifestyle management, risk assessment and referral recommendations, risk factor control, pharmacological treatment, and the application of a CKD management checklist incorporating these components.
Efficacy Evaluation Indicators:
Primary Outcome:
A renal composite endpoint, defined as at least a 25% decline in eGFR, progression to ESRD (dialysis, kidney transplantation, or sustained eGFR <15 mL/min/1.73 m²), or death due to renal or cardiovascular causes.
Secondary Outcomes:
Cardiovascular composite endpoint: cardiovascular death, non-fatal stroke, non-fatal myocardial infarction, and hospitalization for heart failure.
Delayed CKD progression, defined as a reduction in the annual eGFR decline rate by 0.5-1 mL/min/1.73 m² or a 30% reduction in UACR per year.
Proportion of patients receiving guideline-recommended pharmacological treatment.
Safety Evaluation Indicators:
Acute deterioration of renal function (serum creatinine increase >30% within 4 weeks).
New-onset hyperkalemia. Symptomatic hypotension. Recurrent hypoglycemia.
Inclusion: Patients with chronic kidney disease (CKD) (defined as eGFR <60 ml/min/1.73 m² or UACR >30 mg/g on two occasions at least 3 months apart).
Exclusion: Patients with end-stage renal disease (eGFR <15 ml/min/1.73 m²) or those already receiving regular dialysis or kidney transplantation; Age <18 years; Pregnant or breastfeeding women; Patients currently participating in any other clinical trial; Patients who exhibit characteristics during the screening phase that indicate an inability to complete the study.