- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02373384
The Predictors of Successful Oral Dissolution Therapy in Radiolucent Renal Stones; A Prospective Evaluation
Study Overview
Status
Conditions
Detailed Description
Patients with renal stones, seen through the outpatient clinic in the urology department or post primary intervention for renal stones, will be assessed to see if the patient satisfies all inclusion and exclusion criteria. Patients who are meeting these criteria will be asked to participate in this prospective study. If they agree, they will be asked to sign an informed consent.
Baseline patients' assessment will include;
Full history taking including
- Previous stone history regarding presentation and management
- Previous trial oral dissolution therapy for renal stones and their compliance to the treatment
- Previous GIT surgery
- History of chronic medical or metabolic illness e.g; DM
Clinical examination including
o Body mass index (BMI)
Laboratory investigations including;
- Urine analysis (urine PH)
- 24 hours urine testing for uric acid and citrate
- Urine culture
- Serum creatinine
- Random blood sugar (RBS)
- Serum uric acid
- Serum calcium, phosphorus and magnesium.
Initial radiological evaluation will include
- Renal ultrasonography (US)
- Plain X-rays to exclude the presence of calcification in the targeted stone.
- Non Contrast Computed Tomography (NCCT) on the abdomen and pelvis.
- MAG3 diuretic renogram
(All NCCT studies will be performed with multislice helical CT scanners, NCCT images will be obtained from above the kidneys through the bladder base. For each renal stone, its location will be recorded, its size will be measured using the largest dimension from length (L), width (W) and height (H) on axial and coronal reformat images. Its mean density will be recorded by measurement using region of interest just smaller than the stone. Associated hydronephrosis proximal to the stone will be also evaluated (Nakada et al 2000).)
Patient will receive the allocated instructions and medications
Patients' follow up (The aim at follow up is to monitor the urinary PH with adjustment of the dose of potassium citrate and also to assess the compliance of the patients regarding the dietary recommendations and the medications)
After 2 weeks, 4 weeks, 8 weeks and 12 weeks.
- the most important parameter will be assessed is the urinary PH every two weeks. The target urinary PH should be kept between6.5 to 7.0, the dose of potassium citrate should be adjusted to achieve this value.
- Patients' compliance to medications intake and the instruction of fluid intake and dietary modification.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
DK
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Mansoura, DK, Egypt, 35516
- Urology and nephrology center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Patients' criteria:
- Ability to give informed consent.
- Age more than 18 years.
- Absence of significant hydronephrosis, serious urinary tract infection, congenital anomalies or distal ureteric obstruction in the affected renal unit.
- Normal cardiac, hematological, and renal functions.
Stone criteria:
- Primary or recurrent renal stone.
- Patients with residual renal stones after primary intervention whether open surgery, endoscopic or ESWL.
- Peripheral calyceal stones or stone in the renal pelvis with no significant hydronephrosis.
- Stone size less than 3 cm in maximum diameter
- Stones with radiodensity less than 600 Hounsefield units attenuation in Non Contrast Computed Tomography (NCCT).
Exclusion Criteria:
Patients' criteria:
- Inability to give informed consent.
- Age less than 18 years
- Patients with unremitting pain or serious urinary tract infection.
- Presence of significant hydronephrosis, congenital anomalies or distal ureteric obstruction in the affected renal unit.
- Abnormal cardiac, hematological or renal functions.
Stone criteria:
- Obstructing stone in the renal pelvis with significant hydronephrosis.
Assumption of presence of calcium stones by presence of calcification in the stone in plain X-rays.
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Study Plan
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: Study group
Eligible patients, who fulfilled the study criteria, will be instructed For;
In hyperuricosuric patients (24-hours urine uric acid more than 750 mg/day in male and more than 650mg/day in females) ; - Dietary modification will be advised in the form of decrease purine rich diet as red meat and fish, increase vegetables. |
Eligible patients, who fulfilled the study criteria, will be instructed For; Oral alkalinization therapy
Allopurinol, a competitive inhibitor of xanthine oxidase, in a dose of 300 mg daily.
Other Names:
Eligible patients, who fulfilled the study criteria, will be also instructed for; Adequate fluid intake in order to maintain urine volume between 2-3 L per day.
Eligible patients, who fulfilled the study criteria and they are hyperuricosuric (24-hours urine uric acid more than 750 mg/day in male and more than 650mg/day in females) will be also instructed for; Dietary modification will be advised in the form of decrease purine rich diet as red meat and fish, increase vegetables.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The primary endpoint of this study will be change in stone surface area after 3 months of the determined protocol
Time Frame: participants will be followed for the duration of medical treatment which is specified to be 3 months
|
The stone surface area will be measured using the formula; Surface area = length X width X 0.25 X (22/7) Comparison of the stone surface area in relation to the initial surface area will be done.
|
participants will be followed for the duration of medical treatment which is specified to be 3 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment of the predictors of response (more than 50% reduction in the surface area of the stone) to medical treatment
Time Frame: participants will be followed for the duration of medical treatment which is specified to be 3 months
|
The percent reduction of stone surface area will be calculated using the formula: Surface area = length X width X 0.25 X (22/7) Categorization of the patients into three groups will be done:
In the responders groups, factors predicting the success of treatment will be determined |
participants will be followed for the duration of medical treatment which is specified to be 3 months
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The cost efficiency of this procedure
Time Frame: participants will be followed for the duration of medical treatment which is specified to be 3 months
|
Cumulative cost of medical treatment, including cost of medications and cost savings of sparred medical resources of interventional treatment will be assessed.
|
participants will be followed for the duration of medical treatment which is specified to be 3 months
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Ahmed A. Shokeir, MD, Urology And Nephrology Center, Mansoura University, Mansoura
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Kidney Diseases
- Urologic Diseases
- Pathological Conditions, Anatomical
- Urinary Calculi
- Urolithiasis
- Calculi
- Kidney Calculi
- Nephrolithiasis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antirheumatic Agents
- Antimetabolites
- Protective Agents
- Natriuretic Agents
- Diuretics
- Respiratory System Agents
- Antioxidants
- Free Radical Scavengers
- Gout Suppressants
- Expectorants
- Allopurinol
- Potassium Citrate
Other Study ID Numbers
- AEl-Sawy122015
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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