Children’s Hospital of Philadelphia Receives Funding to Launch Largest Trial for Children with Chronic Kidney Disease

CHOP announced that PCORI approved a five year award to fund PRESERVE 2.0 – the largest randomized trial on blood pressure management in children with CKD. Children’s Hospital of Philadelphia (CHOP) announced that the Patient-Centered Outcomes Research Institute (PCORI) approved a five‑year funding award to support PRESERVE 2.0, a research project entitled “Alternative Approaches for Managing Blood Pressure in Children With Chronic Kidney Disease.” The study is set to become the largest randomized controlled trial focused on blood pressure management in children with chronic kidney disease (CKD).Hypertension affects roughly half of children with CKD and is a major, modifiable driver of kidney function decline. Loss of kidney function can lead to kidney failure requiring dialysis or transplant. Despite this, high-quality evidence guiding exactly how tightly to control blood pressure and which drugs to use as first-line therapy in most pediatric CKD patients is limited, resulting in wide practice variation and suboptimal blood pressure control for many children. PRESERVE 2.0 aims to fill these evidence gaps.The five-year study, which evolved from the original PCORnet® designated PRESERVE study, will launch in October 2026 and will be led by Co-Principal Investigators, Michelle Denburg, MD, MSCE and Christopher Forrest, MD, PhD at CHOP. The study will enroll 700 children ages 2 to 17 with CKD stages 2 to 4 across 30 U.S. healthcare institutions within PEDSnet and the other six PCORnet® clinical research networks. Participants will be followed for 24 months to compare two blood pressure goals – the usual target and a lower, more intensive target, and to see which first-line blood pressure medicines work better and are safer. Ultimately, PRESERVE 2.0 will answer two high-priority questions for pediatric CKD care: which clinic blood pressure target best protects kidney and heart health, and which medication class should be used first-line to treat hypertension in children with CKD. Michelle Denburg, MD, MSCE “If successful, PRESERVE 2.0 will provide the strongest available evidence about BP targets and first-line antihypertensive choice for most children with CKD,” said Denburg, who is also an attending physician in CHOP’s Division of Nephrology, and co-director of the Penn-CHOP Kidney Innovation Center. “Results are expected to directly inform clinical practice, guideline development, and shared decision-making tools for children with CKD, their families, and clinicians. Findings will be widely disseminated via webinars, infographics, videos, and professional meetings.”Learn more

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