Starting 4 kidney medicines quickly together in chronic kidney disease with type 2 diabetes
Tests starting 4 kidney medicines quickly together in adults with kidney disease and diabetes.
Plain-language title generated from the registry record
Registry title: Rapid and Simultaneous Initiation of Four Guideline-Directed CKD Therapies (RAPID-CKD)
Key facts
- Where
- Temple, United StatesSee the site
- Phase
- Phase 4
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 84 years old?
Source: NCT07547878, who can take part
Where in United States
- Baylor Scott and White Medical Center TempleTemple, United StatesNo 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
- Baylor Research Institute
- Trial code
- NCT07547878
- Record updated
- 13 October 2026
- Original description
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.Read full original descriptionShow less
A Pilot Randomized Clinical Trial to Assess Feasibility, Safety, and Efficacy of Rapid, Simultaneous Therapy Initiation in Chronic Kidney Disease and Type 2 Diabetes: RAPID-CKD
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
Inclusion: Patients aged 18-84 years; eGFR 45 to ≤90 mL/min/1.73 m2; UACR >200 mg/g; diagnosis of T2D; receiving ≤2 guideline-recommended drug classes irrespective of dose for ≥4 weeks prior to screening; eligible for all 4 drugs; systolic BP (SBP) >90 mmHg; those willing to provide written informed consent and to adhere to study visits.
Exclusion: Type 1 diabetes; any known primary non-diabetic kidney disease (i.e., polycystic kidney disease, glomerulonephritis, interstitial nephritis, etc.); history of kidney transplant; known hypersensitivity to any study drug; active malignancy or infection; brittle diabetes (defined as severe glycemic instability with hospitalization or emergency care for hypoglycemia or hyperglycemia within the past 6 months); SGLT2i: diabetic ketoacidosis, type 1 diabetes, recurrent genitourinary infections; GLP1-RA: personal or family history of medullary thyroid carcinoma, known gastroparesis, or pancreatitis; liver disease (i.e., aspartate transaminase or alanine transaminase >5 times, or bilirubin >3 times the upper limit of normal); serum potassium >5.5 mEq/L at baseline; life expectancy <6 months; high-risk of hypoglycemia (Clarke or Gold score ≥4); predicted 12-month risk of hypoglycemia related emergency visits or hospitalizations >5% using the Kaiser Permanente hypoglycemia prediction score; high dose insulin use (>1 unit/kg/day); RASi: hyperkalemia or angioedema; ns-MRA: hyperkalemia.