Role of Extrarenal 1-Alpha-Hydroxylase in Patients With End Stage Renal Disease

April 10, 2014 updated by: Jason Stubbs, MD, University of Kansas

Exploring the Role of Extrarenal 1-Alpha-Hydroxylase in Patients With End Stage Renal Disease

The goal of this study is to evaluate the role of nutritional Vitamin D deficiency as a potential contributor to the morbidity witnessed in patients with end-stage renal disease

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The goals of this study are to elucidate the function of extrarenal 1 alpha-hydroxylase activity in the setting of renal failure and to evaluate the role of nutritional vitamin D deficiency as a potential contributor to monocyte-associated inflammatory pathways in patients with end-stage renal disease (ESRD). This study will consist of patients on chronic maintenance hemodialysis three times per week who have been identified to have nutritional vitamin D deficiency. After consent for study enrollment, patients will undergo a 4 week washout period of all active vitamin D supplementation. After washout is complete, an blood sample will be obtained for baseline 25(OH)D levels and monocyte isolation for analysis by flow cytometry. Patients will then be started on cholecalciferol 50,000 IU twice weekly for 8 weeks. 25-vitamin D levels will be monitored midway through the treatment phase of the study and dosing adjusted as further described in detail within the protocol section. An additional blood sample will be drawn post-therapy for repeat 25(OH)D levels and monocyte isolation for flow cytometry analysis.

Study Type

Interventional

Enrollment (Actual)

7

Phase

  • Not Applicable

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

21 years to 88 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • End-stage renal disease undergoing maintenance hemodialysis at KUMC outpatient hemodialysis unit
  • Dialysis vintage of at least 6 months duration
  • Nutritional vitamin D deficiency, defined as 25(OH)D <25 ng/ml
  • Age 21 to 88 years

Exclusion Criteria:

  • Active infection
  • Recent hospitalization for acute illness (within last 1 month)
  • Refusal to study participation
  • Poorly controlled secondary hyperparathyroidism (iPTH>500)
  • History of chronic inflammatory disease process, such as inflammatory bowel, rheumatoid arthritis, lupus, etc.
  • Cinacalcet therapy
  • Previous allergy to ergocalciferol
  • History of parathyroidectomy
  • Current treatment with immunosuppressant medications
  • Noncompliance with prescribed hemodialysis regimen (i.e. skipping treatments, ending sessions early)
  • Functional renal transplant within the last five years

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 1
Cholecalciferol (Vitamin D)
Drug: Cholecalciferol
50,000 Units PO Twice weekly for 8 weeks
Other Names:
  • Vitamin D, ergocalciferol

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Monocyte VDR Expression With Vitamin D Therapy
Time Frame: Change from End of Washout to Week 12
Monocytes will be analyzed pre- and post-cholecalciferol by flow cytometry to measure changes in monocyte VDR expression. Unit of measure is represented by mean florescence intensity (MFI), which is a relative measure.
Change from End of Washout to Week 12

Collaborators and Investigators

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

Sponsor

University of Kansas

Investigators

  • Principal Investigator: Jason Stubbs, MD, University of Kansas Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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

May 1, 2008

Primary Completion (Actual)

August 1, 2009

Study Completion (Actual)

August 1, 2009

Study Registration Dates

First Submitted

May 12, 2008

First Submitted That Met QC Criteria

May 13, 2008

First Posted (Estimate)

May 14, 2008

Study Record Updates

Last Update Posted (Estimate)

April 29, 2014

Last Update Submitted That Met QC Criteria

April 10, 2014

Last Verified

April 1, 2014

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 11225 (DAIDS ES Registry ID)

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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