- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02989688
Glycaemic Response to Oral Nutrition Support During Haemodialysis (GRO-HD)
December 7, 2016 updated by: King's College Hospital NHS Trust
Patients with kidney, or renal, failure require life-saving treatment with regular dialysis.
Dialysis is a form of treatment that simulates some kidney functions; to remove harmful waste products and extra water from the blood.
Almost one-third of people with kidney failure also have diabetes, as diabetes is one of the leading causes of kidney disease in the United Kingdom, usually due to poor blood sugar control over a long period of time.
Malnutrition is common in patients needing dialysis due to kidney failure causing fatigue, taste changes and a build up of waste products, which can reduce appetite.
Treatment of malnutrition involves increasing both the energy and protein intake from food and drinks, and milk-drink style specialist nutrition drinks are often given to dialysis patients due to their specific dietary needs.
These nutrition drinks can increase blood sugar levels and optimal control for diabetes may be difficult.
This research study aims to measure the blood sugar response to a "slow-release" sugar nutrition drink specifically designed for dialysis patients, which may result in a lower blood sugar level, compared to standard nutrition drinks, consumed during a dialysis session.
28 patients with diabetes and having regular dialysis treatment will enrol in the study.
Patients will be asked to drink 1 of 3 different nutrition drinks, once a week for 3 weeks during their regular dialysis treatment.
Blood sugar levels will be measured from the blood samples taken from the patient's circulation directly before it enters the dialysis machine over 3 hours and the maximum blood sugar reading and total blood sugar response will be measured.
Differences between the 3 drinks will be tested statistically.
The results will help to advise patients with diabetes and kidney failure on the most suitable type of nutrition drink to consume during dialysis.
Study Overview
Status
Completed
Detailed Description
Patients with end stage kidney disease requiring dialysis are at the highest risk for cardiovascular disease, and many of our dialysis population also have diabetes.
Malnutrition is common in patients undergoing dialysis and causes are multifactorial.
Oral nutrition support is the first line treatment for malnutrition, and often includes the use of liquid nutrition supplements, especially in dialysis patients due to the already restricted diet required to maintain electrolyte balance.
Oral nutrition supplements (ONS) can raise serum blood glucose levels and optimal control for diabetes may be difficult when ONS are required.
This study aims to evaluate the post-prandial response to a newly re-formulated slow release carbohydrate renal specific oral nutrition supplement, compared to standard and macro-nutrient matched ONS products, during haemodialysis, using a randomised cross-over trial design.
28 patients with diabetes and end stage kidney disease undergoing haemodialysis will be recruited to the study, including 8 in the pilot phase and 20 in the study.
Patients will be randomised in a crossover design to 3 study treatments over 3 weeks - slow release CHO ONS, macronutrient matched ONS, and standard ONS.
Central blood glucose levels will be measured over 3 hours and the peak and mean incremental area under the curve (iAUC) of the post prandial blood glucose response will be calculated for each study treatment.
Differences between treatments will be determined with repeated measures analysis of co-variance (ANCOVA).
The acute effect of different nutritional supplements on blood glucose will be discussed in the context of maintaining optimal blood glucose control during dialysis.
Study Type
Interventional
Enrollment (Actual)
24
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
-
-
-
London, United Kingdom, SE5 9RS
- King's College Hospital
-
-
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
18 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Type 1 or type 2 diabetes
- End stage kidney disease on haemodialysis
- Body mass index 18.5-35kg/m2
- Able to provide written informed consent
Exclusion Criteria:
• Infection or course of antibiotics in the last month
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: Crossover Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: modified carbohydrate drink
Dietary Supplement - renal specific slow release carbohydrate ONS (220 ml Nepro HP (Abbott Nutrition)
|
oral nutritional supplement drink with modified carbohydrate composition
|
Active Comparator: macronutrient matched drink
Dietary Supplement - 125 ml Fortisip Compact Protein (Nutricia) plus 20ml Calogen (Nutricia)
|
Fortisip compact protein 125 ml + Calogen 20ml (Nutricia) oral nutritional supplement drink macronutrient matched with standard carbohydrate composition
|
Active Comparator: standard drink
Dietary Supplement - 125 ml Fortisip compact (Nutricia)
|
Fortisip compact 125 ml (Nutricia) oral nutritional supplement drink - standard
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood glucose response curve
Time Frame: 3 hour
|
Mean incremental area under the curve for blood glucose response to intervention over 3 hours
|
3 hour
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Peak blood glucose reading within 3 hours
Time Frame: 3 hours
|
3 hours
|
|
Appetite score pre and post ONS
Time Frame: 3 hours
|
likert scale
|
3 hours
|
Flavour acceptability scale for ONS product
Time Frame: 3 hours
|
likert scale
|
3 hours
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Helen L MacLaughlin, PhD, Clinical Lecturer
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.
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
January 1, 2015
Primary Completion (Actual)
December 1, 2016
Study Completion (Actual)
December 1, 2016
Study Registration Dates
First Submitted
January 20, 2016
First Submitted That Met QC Criteria
December 7, 2016
First Posted (Estimate)
December 12, 2016
Study Record Updates
Last Update Posted (Estimate)
December 12, 2016
Last Update Submitted That Met QC Criteria
December 7, 2016
Last Verified
January 1, 2016
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- KingCHL
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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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