The Measurement of Insulin Resistance in Peritoneal Dialysis Patients

September 22, 2016 updated by: Alp Ikizler, Vanderbilt University
The goal of this study is to examine the relevance of insulin resistance in peritoneal dialysis (PD) patients as well as the means to improve this metabolic derangement. We will do so through a prospective randomized study using Icodextrin as an alternate dialysate solution to routine glucose-based dialysate. We hypothesize that (1) the glucose loading associated with PD leads to impairment in insulin sensitivity, (2) the degree of insulin resistance is dependent on the basal metabolic state (fasting versus stimulated), and (3) the replacement of conventional dialysate with glucose-sparing dialysate preparations will improve insulin resistance and associated metabolic disturbances in PD patients.

Study Overview

Status

Completed

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

10

Phase

  • Not Applicable

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
      • 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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Medically stable and receiving stable PD for ≥ 3 months;
  • BMI ≤ 45;
  • Most recent Kt/V ≥1.7 or Tccr ≥ 50l/week/1.73m2;
  • On Glucose lactate-buffered PD solutions with consistent glucose exposure.

Exclusion Criteria:

  • Pregnancy or breast-feeding;
  • Intolerance to the study protocols;
  • Severe, unstable, active, or chronic inflammation disease (active infection, active connective tissue disorder, active cancer, HIV, liver disease);
  • Chronic use of anti-inflammatory medication except low dose (< 10mg/d) prednisone;
  • Severe hypokalemia (K+ level < 3.0 mEq/L);
  • Hypercalcemia (Ca++ level > 11.0 mg/dL);
  • Have a glycogen storage disease;
  • Intolerant to maltose or isomaltose;
  • Allergic to cornstarch or icodextrin;
  • Recent abdominal surgery in the past 30 days;
  • Chronic Obstructive Lung Disease (COPD) or Interstitial lung disease;
  • Insulin-Dependent Diabetes Mellitus (IDDM).

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: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: glucose-based dialysate
most frequently used Standard of Care (SOC) dialysate
Other: Icodextrin dialysate
alternate SOC dialysate
use of alternate SOC dialysate

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
improvement in glucose disposal rate
Time Frame: 12 weeks
12 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
the Pearson or Spearman correlation coefficient values between insulin resistance (IR) measured by insulin clamp study and other methods (e.g., HOMA, QUICKI, OGTT)
Time Frame: 12 weeks
12 weeks

Collaborators and Investigators

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

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

September 1, 2010

Primary Completion (Actual)

January 1, 2015

Study Completion (Actual)

January 1, 2015

Study Registration Dates

First Submitted

May 5, 2010

First Submitted That Met QC Criteria

May 5, 2010

First Posted (Estimate)

May 7, 2010

Study Record Updates

Last Update Posted (Estimate)

September 26, 2016

Last Update Submitted That Met QC Criteria

September 22, 2016

Last Verified

September 1, 2016

More Information

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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