Association Between DXA Results and the Complications, Clinical Courses and Outcomes in Chronic Dialysis Patients

May 3, 2022 updated by: National Taiwan University Hospital

Aims:

  1. To determine whether BMD and muscle mass were associated with fractures and other adverse events in dialysis patients.
  2. To explore the effects of the interactions among FGF23, calcium, phosphate, PTH and vitamin D on low bone mineral density and sacropenia in dialysis patients.

Method:

In this study, the investigators plan to use DXA to screen for BMD, relevant novel bone microstructure parameters, and body composition in chronic dialysis patients. Also, the investigators plan to use blood testing to measure the blood level of FGF23, calcium, phosphate, PTH and vitamin D. The investigators conduct a prospectively follow up program for these participants to evaluate clinical courses and outcomes. Patients will receive DXA (including BMD and body composition) tests and blood work at baseline and one-year. Muscle power and physical performance will be measured at baseline, 6 months and one-year.

Study Overview

Status

Recruiting

Conditions

Detailed Description

Background:

Several large-scale studies enrolling CKD patients discovered that low BMD is still an important risk factor for developing fragility fractures, while chronic dialysis patients are reported to have 4 to5 fold higher risk of fracture compared to general population. However, the relationship between bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) and fracture and other adverse events in patients with CKD patients is still unclear. In addition, declining of renal function could affect the normal physiological regulating of blood levels of calcium, phosphate, fibroblast growth factor 23 (FGF23), parathyroid hormone (PTH), and vitamin D, which could influence the bone mineral density of chronic dialysis patients. Recently, it is well known that serum FGF23 is already elevated at the early stage of CKD patients and independently related to CKD. However, there are a limited number of reports indicate that the effects of the interactions among FGF23, calcium, phosphate, PTH and vitamin D on low bone mineral density and sacropenia in CKD patients.

Aims:

  1. To determine whether BMD by DXA was associated with fractures and other adverse events in dialysis patients.
  2. To explore the effects of the interactions among FGF23, calcium, phosphate, PTH and vitamin D on low bone mineral density and sacropenia in dialysis patients.

Method:

In this study, the investigators plan to use DXA to screen for BMD, relevant novel bone microstructure parameters, and body composition in chronic dialysis patients. Also, the investigators plan to use blood testing to measure the blood level of FGF23, calcium, phosphate, PTH and vitamin D. The investigators conduct a prospectively follow up program for these participants to evaluate clinical courses and outcomes.

Patient characteristics

Inclusion Criteria:

  1. Age >20 years and one of the below
  2. Chronic hemodialysis
  3. Chronic peritoneal dialysis

Exclusion Criteria:

get pregnant or planning a pregnancy

Anticipated results:

  1. The investigators expect that results and findings discovered from this study could show the effects of interactions of FGF23, calcium, phosphate, PTH and vitamin D on low bone mineral density and sacropenia in CKD patients, which should be an important step on improving clinical decision for osteoporosis and fracture risk in renal dialysis patients.
  2. Publishing results in an academic journal.

Study Type

Observational

Enrollment (Anticipated)

60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Hsinchu, Taiwan, 31604
        • Recruiting
        • National Taiwan University Hospital, Chutung branch
        • Contact:
        • Principal Investigator:
          • Ding-Cheng Chan, MD,PHD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Chronic Kidney Disease Requiring Chronic Dialysis

Description

Patient characteristics

Inclusion Criteria:

  1. Age >20 years and one of the below
  2. Chronic hemodialysis
  3. Chronic peritoneal dialysis

Exclusion Criteria:

1. get pregnant or planning a pregnancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Case-Only
  • Time Perspectives: Other

Cohorts and Interventions

Group / Cohort
chronic dialysis
Patient enrolled at the National Taiwan University Hospital Jinshan branch

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bone mineral density by DXA,
Time Frame: one year
Change of BMD between baseline and one year was measured
one year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood tests
Time Frame: one year
Change of baseline and one year value of various blood tests mentioned in the summary
one year
Sarcopenia
Time Frame: baseline, 6 month and one year
Changes of saropenia percentage at 6 month and one year compared to baseline assessments. 3 measures were used, muscle mass, grip strength, and walking speed
baseline, 6 month and one year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Ding-Cheng Chan, MD, PhD, National Taiwan University Hospital, Chutung branch

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2015

Primary Completion (Actual)

March 1, 2021

Study Completion (Anticipated)

February 1, 2026

Study Registration Dates

First Submitted

November 25, 2015

First Submitted That Met QC Criteria

November 27, 2015

First Posted (Estimate)

November 30, 2015

Study Record Updates

Last Update Posted (Actual)

May 4, 2022

Last Update Submitted That Met QC Criteria

May 3, 2022

Last Verified

May 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • 201505154RINB

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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