- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02831062
Nutritional Therapy to Prevent Progression of Acute Kidney Injury to Chronic Kidney Disease (NutriAKI)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a pilot single center, randomized controlled, trial of patients who have an episode of Stage 2/3 AKI and are followed in a focused post-AKI clinic. Patients will be randomize to either; a. LPD-K diet containing 0.6 g protein/kg per day, phosphorus 5-10 mg/kg/day, Ketosteril 1 capsule per 5 kg body weight/day divided over three doses (max 8 capsules per dose) or b. ad lib diet. Ketosteril should be takes daily during meals and the tablets must not be chewed. Ingestion during meals facilitates proper absorption and the metabolisation into the corresponding amino acids.
After the initial assessment, those randomized to LPD-K will be on this diet for a maximum of 90 days. Additional interventions will include dietary counselling and questionnaire in both groups. We would aim for maintaining serum bicarbonate levels ≥ 22meq/L in both groups.
Evaluation of renal function will be performed using blood and urine tests. In addition, specimens will be collected in a bio-repository, and tested for biomarkers of renal structural damage. Comprehensive nutritional assessment will be performed by a dietitian, along with bioelectrical impedance measurements, blood and urine tests. 24-hour urine urea nitrogen and food records will be used to estimate the protein intake of each individual. Quality of well-being will be assessed using a standardized tool such as Euro Quality of Life (EQ-5D), Charlson Index, and Short Form 8 (SF8) or equivalent. Relevant clinical events (adherence to follow-up, death, hospitalization, renal recovery, repeat AKI episodes) will be tracked throughout the study.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Duration of stage 2/3 AKI episode ≥ 72 hrs and ≤ 21 days
- Total hospital stay ≤ 21 days
Exclusion Criteria:
- Baseline Chronic Kidney Disease Stage 4 or higher (estimated Glomerular Filtration Rate (eGFR)) <30ml/min/1.73m2) prior to their AKI episode
- Patients dialysis dependent at hospital discharge
- Dialysis dependency > 14 days at time of enrolment
eGFR exclusion criteria:
- for patients that required dialysis during hospital stay - measured GFR less than 15ml/min and/or urine output less than 500ml at hospital discharge
- for patients with known baseline serum creatinine (SCr) - renal recovery with an eGFR more than 80% from baseline at hospital discharge
- for patients with unknown previous renal function - eGFR > 60ml/min/1.73m2 at time of hospital discharge
- Suspected or biopsy proven glomerulonephritis as cause of AKI
- Obstructive nephropathy as cause of AKI.
- Kidney transplant recipient and patients in the kidney transplant list
- Chronic liver disease
- High likelihood of re-hospitalization or death in the following 6 months, ascertained by physician in charge of the patient.
- Hypercalcemia - Ca > within one standard deviation of reference level upper limit or albumin corrected
- Lactating or pregnant woman or woman planning to become pregnant within the timeframe of the study
- Inability to follow up study procedures for at least 6 months
- Unwillingness to give consent
- Institutionalized individuals (prisoners, significant mental illness, or nursing home residents)
- Body weight <70% or >150% of standard body weight
- History of phenylketonuria or other major disorder of amino acid metabolism
- Hypersensitivity to the active substances or to any of the excipients of Ketosteril.
Study Plan
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: ad lib diet
Patients who have an episode of Stage 2/3 AKI and are followed in a focused post-AKI clinic.
Patients will be asked to continue on their regular diet and the protein and caloric ingestion will be recorded at each visit.
|
|
Experimental: Low Protein Diet + Ketosteril
Patients who have an episode of Stage 2/3 AKI and are followed in a focused post-AKI clinic.
Patients in this arm will be prescribed a low protein diet (LPD) and +Ketosteril supplementation, containing 0.6 g protein/kg per day, phosphorus 5-10 mg/kg/day, Ketosteril 1 capsule per 5 kg body weight/day divided over three doses (max 8 capsules per dose).
Protein and caloric ingestion will be recorded.
|
Patients will follow a diet containing 0.6 g protein/kg per day, phosphorus 5-10 mg/kg/day, Ketosteril 1 capsule per 5 kg body weight/day divided over three doses (max 8 capsules per dose).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
feasibility of the LPD-K diet
Time Frame: 6 months
|
Feasibility: assess the compliance with diet and drug.
Compliance to the assigned protein prescription will be estimated at each visit during the intervention period by nutrient intake data obtained from 3-day food records and the estimated protein intake calculated from urinary nitrogen appearance in 24-hour urine samples.
Treatment compliance will be assessed by counting returned tablets.
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
degree of recovery of renal function
Time Frame: 6 months
|
percentage of renal function recovery using baseline estimated GFR as reference. Recovery will be considered as
|
6 months
|
rate of recovery of renal function
Time Frame: 6 months
|
Slope of renal function recovery using baseline estimated GFR as reference.
|
6 months
|
safety of the LPD-K diet
Time Frame: 6 months
|
Evaluate adverse events related to ketosteril by monitoring serum calcium levels at each visit to determine the development of hypercalcemia Serum calcium levels > 10.5 mg/dl
|
6 months
|
Collaborators and Investigators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
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
Other Study ID Numbers
- 151843
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
Clinical Trials on Chronic Kidney Disease
-
3-C Institute for Social DevelopmentUniversity of North Carolina, Chapel HillCompletedChronic Kidney Diseases | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage4 | Pediatric Kidney Disease | Chronic Kidney Disease stage3 | Chronic Kidney Disease Stage V | Chronic Kidney Disease, Stage IV (Severe) | Chronic Kidney Disease Stage 2 | Chronic Kidney Disease, Stage IUnited States
-
Universiti Putra MalaysiaRecruitingChronic Kidney Diseases | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage4 | Chronic Kidney Disease stage3 | Chronic Kidney Disease Requiring Chronic DialysisMalaysia
-
National Taiwan University HospitalCompletedChronic Kidney Disease stage4 | Chronic Kidney Disease stage3 | Chronic Kidney Disease Stage 2 | Chronic Kidney Disease Stage 1Taiwan
-
Centre Hospitalier le MansLe Mans UniversiteWithdrawnFatigue | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage3 | Chronic Kidney Failure | Chronic Kidney Disease, Stage 4 (Severe)
-
Centre Hospitalier le MansLe Mans UniversiteRecruitingFatigue | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage4 | Chronic Kidney Disease Stage 3BFrance
-
American Academy of Family PhysiciansUniversity of Colorado, Denver; National Institute of Diabetes and Digestive... and other collaboratorsCompletedChronic Kidney Disease | Chronic Renal Insufficiency | Chronic Kidney Insufficiency | Chronic Renal Diseases | Kidney Insufficiency, ChronicUnited States
-
Lund UniversityBaxter Healthcare Corporation; Universidad de CórdobaCompletedEnd Stage Kidney Disease | Chronic Kidney Disease Requiring Chronic DialysisArgentina
-
Centre Hospitalier Saint Joseph Saint Luc de LyonNot yet recruitingKidney Failure, Chronic | Diet Habit | Chronic Kidney Disease stage3 | Chronic Kidney Disease Stage 3B | Chronic Kidney Disease, Stage 3 (Moderate) | Chronic Kidney Disease Stage 3A (Disorder)France
-
A.C. AbrahamsCompletedEnd Stage Renal Disease | Chronic Kidney Disease | End Stage Kidney Disease | Chronic Kidney FailureNetherlands
-
Far Eastern Memorial HospitalActive, not recruitingMetabolic Syndrome | Chronic Disease | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease Stage 3 | Chronic Kidney Disease Stage 4 | Chronic Kidney Disease Stage 2 | Chronic Kidney Disease Stage 1Taiwan
Clinical Trials on low protein diet + ketosteril
-
Chulalongkorn UniversityNot yet recruitingHemodialysis | Kidney Function
-
Anemia Working Group RomaniaDr Carol Davila Teaching Hospital of Nephrology BucharestCompletedChronic Kidney DiseaseRomania
-
Huashan HospitalNot yet recruitingChronic Kidney Disease | SarcopeniaChina
-
Military Institute of Medicine, PolandMedical University of Lodz; Medical University of WarsawRecruiting
-
Fresenius KabiCompleted
-
Azienda Sanitaria ASL Avellino 2UnknownChronic Renal InsufficiencyItaly
-
University of BonnFederal Ministry of Food and Agriculture (BMEL); Federal Office for Agriculture...RecruitingCardiovascular Diseases | Metabolic SyndromeGermany
-
Indiana UniversityIndiana University School of MedicineCompletedProstate Cancer RecurrentUnited States
-
University of CopenhagenThe Danish Dairy Research Foundation, Denmark; Nordea-Fonden, Denmark; LEGO Charity... and other collaboratorsActive, not recruitingObesity | Pregnancy | Gestational Age and Weight Conditions | Maternal Care for Excessive Fetal Growth | Metabolic DisordersDenmark
-
The Third Xiangya Hospital of Central South UniversityUnknownRenal Insufficiency, ChronicChina