- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00368017
Metabolic Effects of Thiazolidinediones in Chronic Kidney Disease
November 1, 2010 updated by: Vanderbilt University
The substantially increased cardiovascular morbidity and mortality rates in chronic kidney disease (CKD) patients cannot be sufficiently explained by traditional coronary risk factors.
It is apparent that inflammation of the vessel wall plays an essential role in the pathophysiology of atherosclerosis, and the strong association between elevated inflammatory biomarkers and cardiovascular death further supports this mechanism.
Approximately 50% of the mortality in this population of patients is attributable to cardiovascular disease.
Insulin resistance is also a common problem in uremic patients.
It has been shown that insulin resistance may contribute to atherosclerotic cardiovascular disease.
An intriguing observation in CKD patients with advanced uremia is that the metabolic profile of these patients is characterized by persistent low-grade inflammation, a state of insulin resistance, and significantly increased prevalence of atherosclerosis.
It is possible that these metabolic derangements can be the inciting factors for development and progression of uremic atherosclerosis.
Peroxisome proliferator-activated receptor gamma (PPAR-gamma) is a ligand-activated nuclear transcription factor found in cells of the immune system and the vasculature, where it exerts an overall protective effect on the development of atherosclerosis, in part through modulation of inflammation.
The agonists for PPAR-gamma improve not only the insulin resistance, but also have profound beneficial effects on inflammation, oxidative stress, endothelium, and lipid metabolism.
In this proposal, the investigators hypothesize that short-term administration of a PPAR-gamma agonist (pioglitazone) will improve the inflammatory state, insulin resistance, and endothelial dysfunction in chronic kidney disease patients with advanced uremia.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
12
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University Medical Center
-
-
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
18 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients with Stage 3 or 4 chronic kidney disease as measured by a Modification in Diet in Renal Disease Study (MDRD) estimate of between 15 ml/min and 59 ml/min.
- Age between 18 and 75 years old.
- Patients without hospitalization for cardiac or infection related morbidity over the previous four weeks (due to the potential confounding effects on baseline study variables).
- Patients who are able to provide consent to participate in the study.
Exclusion Criteria:
- Patients with prior documented diagnosis of diabetes mellitus.
- Patients with fasting blood glucose > 110mg/dL.
- Prisoners, patients will significant mental illness, pregnant women, and other vulnerable populations.
- Patients with active hepatic disease and/or ALT > 2.5 times upper limit of normal.
- Patients with history of congestive heart failure and NYHA Class III-IV symptoms at any time.
- Patients for whom living donor renal transplantation is already scheduled or in the process of being evaluated, as these patients will be unlikely to complete study protocols before transplantation.
- Patients with severe co-morbid conditions (eg, symptomatic hepatic cirrhosis, metastatic cancer, HIV infection with AIDS).
- Patient with active inflammatory process (eg., SLE, rheumatoid arthritis, gout) for which they are currently receiving immune modulating medications.
- Patients who are on corticosteroid therapy.
- Patients who do not consent to participate in the study.
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
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: 2
|
1 pill once a day for 12 weeks
|
Active Comparator: 1
|
30 mg once a day for 12 weeks
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
A decrease in C-reactive protein (CRP) levels
Time Frame: 14 weeks
|
14 weeks
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Improved insulin resistance
Time Frame: 14 weeks
|
14 weeks
|
Improved endothelium-dependent vasodilation
Time Frame: 14 weeks
|
14 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Alp Ikizler, MD, Vanderbilt University Medical Center
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
April 1, 2006
Primary Completion (Actual)
September 1, 2007
Study Completion (Actual)
September 1, 2007
Study Registration Dates
First Submitted
August 23, 2006
First Submitted That Met QC Criteria
August 23, 2006
First Posted (Estimate)
August 24, 2006
Study Record Updates
Last Update Posted (Estimate)
November 3, 2010
Last Update Submitted That Met QC Criteria
November 1, 2010
Last Verified
November 1, 2010
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 060042
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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