Study for the Effectiveness of Intensive Therapy Aiming at a Remission of Diabetic Nephropathy
Study for the Effectiveness of Intensive Therapy for Diabetic Nephropathy in Unblinded, Randomized Intergroup Comparison Study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Okayama, Japan, 700-8558
- Okayama University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with type 2 diabetes
- Urinary albumin-to-creatinine ratio: >=300 mg/g creatinine twice in the first morning urine sample
- Serum creatinine level: =<2.5 mg/dl
- Patients aged 20-75 years
Exclusion Criteria:
- Type 1 diabetes
- Hereditary diabetes or secondary diabetes
- Non-diabetic nephropathy
- Familial hypercholesterolemia
- Secondary hypertension
- Unstable angina pectoris or history of myocardial infarction/stroke within 6 months prior to consent acquisition
- Malignant tumor or life threatening disease
- History of angioedema
- Patients undergoing LDL apheresis
- Biliary system obstruction or severe liver injury
- Liver dysfunction
- Allergy for ACE-Is, ARBs or HMG-CoA reductase inhibitors
- Pregnant or nursing patients
- Others: patients who are not suitable for this trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intensive multifactorial therapy (Protocol A)
Protocol A: serum creatinine <1.2 mg/dl in male and <1.0 mg/dl in female.
|
Blood glucose control: HbA1c < 6.2% Blood pressure control: SBP < 125 mmHg, DBP: < 75 mmHg Lipid profile: T-cho < 180 mg/dl, LDL-cho < 100 mg/dl, HDL-cho >40 mg/dl Dietary intervention: TDEI < 30 kcal/kg/day, sodium < 5 g/day, protein < 0.8 g/kg/day Pharmacological intervention: ACE-Is or ARBs, HMG-CoA reductase inhibitors, multivitamins Instruction by co-medicals: Taking medicines, smoking cessation, nutrition care
|
|
Active Comparator: Standard therapy (Protocol A)
Protocol A: serum creatinine <1.2 mg/dl in male and <1.0 mg/dl in female.
|
Blood glucose control: HbA1c < 6.9% Blood pressure control: SBP < 130 mmHg, DBP: < 80 mmHg Lipid profile: T-cho < 200 mg/dl, LDL-cho < 120 mg/dl, HDL-cho >40 mg/dl, Dietary intervention: TDEI < 25-30 kcal/kg/day, sodium < 6 g/day, protein < 1.0 g/kg/day Pharmacological intervention: No restrictions (continuing prior therapy) Instruction by co-medicals: No restrictions (continuing prior therapy)
|
|
Experimental: Intensive multifactorial therapy (Protocol B)
Protocol B: serum creatinine: 1.2-2.5 mg/dl in male and 1.0-2.5 mg/dl in female.
|
Blood glucose control: HbA1c < 6.2% Blood pressure control: SBP < 125 mmHg, DBP: < 75 mmHg Lipid profile: T-cho < 180 mg/dl, LDL-cho < 100 mg/dl, HDL-cho >40 mg/dl Dietary intervention: TDEI < 30 kcal/kg/day, sodium < 5 g/day, protein < 0.8 g/kg/day Pharmacological intervention: ACE-Is or ARBs, HMG-CoA reductase inhibitors, multivitamins Instruction by co-medicals: Taking medicines, smoking cessation, nutrition care
|
|
Active Comparator: Standard therapy (Protocol B)
Protocol B: serum creatinine: 1.2-2.5 mg/dl in male and 1.0-2.5 mg/dl in female.
|
Blood glucose control: HbA1c < 6.9% Blood pressure control: SBP < 130 mmHg, DBP: < 80 mmHg Lipid profile: T-cho < 200 mg/dl, LDL-cho < 120 mg/dl, HDL-cho >40 mg/dl, Dietary intervention: TDEI < 25-30 kcal/kg/day, sodium < 6 g/day, protein < 1.0 g/kg/day Pharmacological intervention: No restrictions (continuing prior therapy) Instruction by co-medicals: No restrictions (continuing prior therapy)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Urinary protein/creatinine ratio (in the first morning urine sample) in Protocol A
Time Frame: 5 years
|
5 years
|
|
Composite endpoint of time to first occurrence of (1) Doubling of serum creatinine, (2) Need for chronic dialysis or renal transplantation, or (3) Death in Protocol B
Time Frame: 5 years
|
5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
GFR in Protocol A
Time Frame: 5 years
|
5 years
|
|
Cardiovascular event in Protocol A
Time Frame: 5 years
|
5 years
|
|
Progression of retinopathy in Protocol A
Time Frame: 5 years
|
5 years
|
|
Urinary albumin/creatinine ratio in Protocol A
Time Frame: 5 years
|
5 years
|
|
Proteinuria (24 h collection sample) in Protocol A
Time Frame: 5 years
|
5 years
|
|
GFR in Protocol B
Time Frame: 5 years
|
5 years
|
|
Cardiovascular event in Protocol B
Time Frame: 5 years
|
5 years
|
|
Progression of retinopathy in Protocol B
Time Frame: 5 years
|
5 years
|
|
Urinary albumin/creatinine ratio in Protocol B
Time Frame: 5 years
|
5 years
|
|
Urinary protein/creatinine ratio in Protocol B
Time Frame: 5 years
|
5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Hirofumi Makino, M.D., Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- DNETT-Japan
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