Effect of Sevelamer on Glucose Tolerance and Insulin Sensitivity in Patients With Chronic Renal Failure (CKD) (SIR)
Study of the Effect of Treatment With Sevelamer on Glucose Tolerance and Insulin Sensitivity in Patients With Chronic Renal Failure
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Gothenburg, Sweden, 413 45
- Sahlgrenska University Hospital
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Stockholm, Sweden, 14186
- Karolinska University Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male or female patients 18-80 years of age with chronic renal failure treated with maintenance HD for >3 months.
Exclusion Criteria:
- Diabetes mellitus
- Treatment with sevelamer within 3 months prior to enrollment
- Acute, clinically significant inflammation within 1 month prior to enrollment
- Pregnancy or breast-feeding
- Clinically significant obstipation or bowel obstruction
- Discontinuation of previous sevelamer treatment because of side effects
- Expected time in HD < 1 year
- Unwillingness to undergo the investigations and follow-up required in the the protocol
- Patients who have received any investigational drug within 1 month prior to enrolment
- Participation in another study, which may interfere with the present study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 1
Sevelamer intervention
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sevelamer tablets, 800 mg (Renagel(r), Genzyme Inc).
The initial daily dose of sevelamer will be 2400 mg (800 mg x 3).
After the first week of treatment the dose will be increased to 4800 mg.
If treatment with sevelamer is well tolerated and if a phosphate concentration of <1.8 mmol/l is not obtained, the dose may be increased further.
The maximum daily dose of sevelamer will be 9600 mg.
If a patient experiences side effects, the dose of sevelamer will be reduced to the highest acceptable dose, and, if a phosphate concentration of <1.8 mmol/l is not obtained, the treatment will be supplemented with calcium carbonate in a dose tolerated by the patient.
Other Names:
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Active Comparator: 2
Calcium carbonate
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Calcium carbonate tablets, 250 mg (Kalcidon, Abigo AB).
Calcium carbonate will be prescribed at the dose given prior to the washout period.
The dose will be adjusted weekly to obtain a serum phosphate concentration <1.8 mmol/l.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Change in insulin sensitivity and/or glucose tolerance from baseline to the end of the study, as obtained by ISIOGTT.
Time Frame: Week 12
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Week 12
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change from baseline to the end of the trial in surrogate markers of phosphate balance (PTH, s-urea, s-creatinine, ionized Ca, phosphate).
Time Frame: Week 12
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Week 12
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Change from baseline to end of the study in markers of lipid homeostasis (total cholesterol, LDL, HDL, ApoA, ApoB, TG, free fatty acids)
Time Frame: Week 12
|
Week 12
|
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Change from baseline to the end of the study in circulating inflammatory cytokines (hsCRP, TNF, fibrinogen, PAI, fetuin)
Time Frame: Week 12
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Week 12
|
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Number of adverse events directly attributable to sevelamer or calciumcarbonate treatments.
Time Frame: Weekly until end of study
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Weekly until end of study
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Anders Alvestrand, MD PhD, Karolinska Institutet
- Principal Investigator: Jonas Axelsson, MD, PhD, Karolinska Institutet
Publications and helpful links
Study record dates
Study Major Dates
Study Start
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 (Estimate)
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
- Glucose Metabolism Disorders
- Metabolic Diseases
- Urologic Diseases
- Hyperinsulinism
- Renal Insufficiency, Chronic
- Phosphorus Metabolism Disorders
- Kidney Diseases
- Kidney Failure, Chronic
- Renal Insufficiency
- Insulin Resistance
- Hyperphosphatemia
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Gastrointestinal Agents
- Calcium-Regulating Hormones and Agents
- Chelating Agents
- Sequestering Agents
- Antacids
- Calcium
- Sevelamer
- Calcium Carbonate
Other Study ID Numbers
Other Study ID Numbers
- SIR_CT_CLINTEC_01
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