- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01041963
The Effect of Enalapril and Losartan on Peritoneal Membrane in Continuous Ambulatory Peritoneal Dialysis Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Detailed description:
Many peritoneal dialysis patients suffer from uremia due to inadequate dialysis or volume overload caused by failure of peritoneal membrane transport.One of the most important etiologies of peritoneal membrane failure are unavoidable to use high glucose-containing dialysate solution that induce injury to mesothelial cell.Previous data found that injured mesothelial cell produces Angiotensin (Ang) II to induce peritoneal inflammation and fibrosis. Blockade of the renin-angiotensin system by angiotensin-converting enzyme inhibition(ACEI) or angiotensin receptor antagonism (ARB) play a major role to slow this effect.
Although many trials in animal study have proved the benefit of ACEI and ARB in peritoneal membrane transport but clinical evidences in human are controversy. Up to now, all previous trials have limitation. First,The trials have small number of population(less than 20 in prospective randomized controlled trial). Second, The trials have multiple confounders on the study population because of the study include old case (that on peritoneal dialysis for many years) and new case (that just start treatment less than 1 year). Third, short duration of study(less than 3 months) to see the significant effect of RAAS blockade on peritoneal membrane transport. Forth, most study use dialysate albumin loss as an index of peritoneal membrane transport ,that less sensitivity to predict peritoneal membrane function. Fifth,no previous trials are attempted to study the effect of combination between ACEI and ARB. Therefore,we design to study the effect of both ACEI and ARB in a larger number of population, only in new case which are just recently found to be on peritoneal dialysis, our study is taken in longer duration and use both modified peritoneal equilibrium test and dialysate CA125 as an index of peritoneal membrane (physiology and anatomic index).This research will demonstrate efficacy of Enalapril and Losartan on Peritoneal membrane transportation lead to improve quality of life in CAPD patients.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Talerngsak Kanjanabuch, Assist. Prf.
- Phone Number: 211 662-2564321
- Email: golfnephro@yahoo.com
Study Locations
-
-
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Bangkok, Thailand, 10330
- Recruiting
- Chulalongkorn University
-
Contact:
- Talerngsak Kanjanabuch, Assist. Prf.
- Phone Number: 211 662-256-4321
- Email: golfnephro@yahoo.com
-
Principal Investigator:
- Talerngsak Kanjanabuch, Assist. Prf.
-
Sub-Investigator:
- Wassawon Wontanatawatot, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All patients received CAPD more than 1 months but less than 1 year
- Subjects of either sex, more than 20 years old
- Hypertension
- Provision of written informed consent by subject or guardian
Exclusion Criteria:
- No history of taking an ACE inhibitor or angiotensin-receptor blockers or aldosterone antagonist for at least 2 month
- Serum potassium more than 5.5 mEq/L
- History of renal artery stenosis
- Peritonitis or volume overload within the preceding 1 month
- Myocardial infarction within the preceding 6 months or clinically significant valvular disease or any active cardiovascular disease
- History of malignant hypertension or hypertensive encephalopathy or cerebrovascular accident within the preceding 6 months
- Any condition that may have precluded a patient from remaining in the study, such as alcohol or drug abuse, chronic liver disease, malignant disease, or psychiatric disorder
- History of allergy or intolerance to an ACE inhibitor or ARB
- Hypotension defined as systolic blood pressure less than 90 mmHg
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Enalapril
|
Patients with hypertension will take 20-40mg enalapril per day, antihypertensive agents other than ACE inhibitors and ARBs and spironolactone will be allowed.
Doses are adjusted appropriately to achieve and maintain the target blood pressure of 130/80 mmHg
Other Names:
|
Active Comparator: Enalapril plus Losartan
|
Patients with hypertension will take 20-40mg enalapril plus 25-50mg losartan per day, antihypertensive agents other than ACE inhibitors and ARBs and spironolactone will be allowed.
Doses are adjusted appropriately to achieve and maintain the target blood pressure of 130/80 mmHg
Other Names:
|
Placebo Comparator: Control
Drug: antihypertensive agents, except ACE inhibitors and ARBs and spironolactone.
Administration of antihypertensive agents will select as follows : CCB→β-blocker→α-blocker-->hydralazine
|
Patients in the control group will administer antihypertensive agents, except ACE inhibitors and ARBs and spironolactone.
Doses are adjusted appropriately to achieve and maintain the target blood pressure of 130/80 mmHg
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change in dialysate CA-125 and modified peritoneal equilibrium test
Time Frame: 12 months
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Dialysis adequacy, residual renal function, hospitalization, peritonitis episodes, any adverse drug effects, death from any cause
Time Frame: every 1 month, except for dialysis adequacy evaluate every 3 mo
|
every 1 month, except for dialysis adequacy evaluate every 3 mo
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Talerngsak Kanjanabuch, Assist. Prf., Chulalongkorn University
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 203/52
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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