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Pharmacokinetics of Zoledronic Acid in Patients on Dialysis (ZADIAL)

4. september 2026 opdateret af: Rodrigo Bueno de Oliveira, University of Campinas, Brazil

Pharmacokinetics of Zoledronic Acid in Patients With Chronic Kidney Disease on Dialysis

Osteoporosis is a frequent complication of chronic kidney disease (CKD) on dialysis, with an estimated prevalence of approximately 40%. It is associated with increased fracture risk, reduced quality of life, and higher mortality. Despite available therapies, management often remains suboptimal, partly due to limited evidence on the safety and pharmacokinetics of bisphosphonates in this population. Objectives: To understand the pharmacokinetics of zoledronic acid in CKD patients on dialysis, as well as to analyze its effects on biomarkers of bone metabolism, bone mineral density (BMD), and clinical outcomes. Materials and Methods: This prospective clinical study involves 24 adult individuals, 8 with CKD-associated osteoporosis (control group; estimated glomerular filtration rate (eGFR) ≥ 35 mL/min/1.73 m²) and 16 with CKD-associated osteoporosis anuric on dialysis patients. Individuals undergoing dialysis will be assigned to receive zoledronic acid at doses of 2.5 mg or 5 mg intravenously (single dose, at the beggining of dialysis session), while patients with CKD-associated osteoporosis (control group; estimated glomerular filtration rate (eGFR) ≥ 35 mL/min/1.73 m²) will receive 5 mg, also in a single dose. Serial blood samples will be collected after infusion, during dialysis session and again up to 96h after dialysis session initiation. The dialysate will be continuously sampled in a tank and aliquots collected for further analysis. The plasma levels of zoledronic acid will be calculated from blood and dialysate samples using liquid chromatography mass spectrometry. The primary outcome is the plasma concentration-time curve of zoledronic acid during a regular dialysis session. Secondary outcomes are: (i) plasma concentration of zoledronic acid up to 96h;(ii) the total mass of zoledronic acid extracted by the dialysate; (iii) the dialytic clearance of zoledronic acid. Evaluation of bone biomarkers (e.g., PTH, alkaline phosphatase, calcium, phosphorus, CTX, and P1NP) and BMD (assessed by bone densitometry) will be performed at baseline and at 12 months. The study will be conducted at the UNICAMP Clinical Hospital, with the participation of one participating center, subject to prior approval from the respective Research Ethics Committees. All participants will be included only after signing the Informed Consent Form. Data will be anonymized and processed in accordance with the General Data Protection Law (LGPD). Expected results: To characterize the pharmacokinetic profile and establish the best dosage regimen of zoledronic acid in patients with CKD on dialysis; to observe the impact of the drug on biomarkers of bone metabolism and BMD.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

24

Fase

  • Fase 1

Kontakter og lokationer

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Studiekontakt

  • Navn: Rodrigo B de Oliveira, PhD
  • Telefonnummer: +55 19 35217366
  • E-mail: rbo@unicamp.br

Undersøgelse Kontakt Backup

Studiesteder

    • São Paulo
      • Campinas, São Paulo, Brasilien, 13083-887
        • School of Medical Sciences, University of Campinas
        • Kontakt:
          • Rodrigo B de Oliveira, PhD
          • Telefonnummer: +55 19 35217366
          • E-mail: rbo@unicamp.br

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Individuals aged 18 years or older, with CKD-associated osteoporosis
  • eGFR ≥ 35 mL/min/1.73 m2 and advanced CKD on dialysis
  • Agree to participate in the research by signing the informed consent form

Exclusion Criteria:

  • Individuals under 18 years of age, pregnant or breastfeeding women
  • Patients with CKD with hypocalcemia/hypophsphatemia
  • Patients with CKD on dialysis with residual diuresis > 100 mL/24h*
  • Patients with CKD on low-flux membrane dialysis*
  • Patients with neoplasia
  • Hypersensitivity to bisphosphonates, or previous use of the medication
  • Inadequate oral condition or anticipated invasive dental procedure within the next 12 months
  • Alkaline phosphatase < 98 IU/L or > 180 IU/L*
  • PTH < 130 pg/mL and > 585 pg/mL*
  • CTX < Lower Limit of Normal (LLN) or
  • CTX < Upper Reference Limit (URL)*
  • Severe liver disease
  • Severe heart disease
  • Clinical suspiction of osteomalacia or adynamic bone disease
  • Cytopenias, defined as: platelets < 120,000/mm³, neutrophils < 3,000/mm³, lymphocytes < 1,000/mm³ and hematocrit < 26% * Applicable only to the group of patients undergoing dialysis.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Control group
CKD-associated osteoporosis in patients with eGFR >= 35 mL/min, allocated to receive conventional dose (5 mg, single dose).
Zoledronic Acid Injection, 5.0 mg, single dose for patients with CKD-associated osteoporosis with eGFR >= 35 mL/min.
Zoledronic Acid Injection, 5.0 mg, single dose, for patients with CKD-associated osteoporosis on dialysis, at the beginning of dialysis session.
Eksperimentel: CKD_Dialysis_2.5
CKD-associated osteoporosis in patients on dialysis, allocated to receive reduced dose (2.5 mg, single dose), at the beginning of dialysis session.
Zoledronic Acid Injection, 2.5 mg, single dose, for patients with CKD-associated osteoporosis on dialysis, at the beginning of dialysis session.
Eksperimentel: CKD_Dialysis_5.0
CKD-associated osteoporosis in patients on dialysis, allocated to receive conventional dose (5 mg, single dose), at the beginning of dialysis session.
Zoledronic Acid Injection, 5.0 mg, single dose for patients with CKD-associated osteoporosis with eGFR >= 35 mL/min.
Zoledronic Acid Injection, 5.0 mg, single dose, for patients with CKD-associated osteoporosis on dialysis, at the beginning of dialysis session.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Area Under the Curve of zoledronic acid (ng.mL/mL)
Tidsramme: From the start of dialysis session to ninety six hours (96 hours) post- drug administration.
Area under the curve of the plasma concentration-time curve of zoledronic acid
From the start of dialysis session to ninety six hours (96 hours) post- drug administration.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total mass of zoledronic acid extracted by the dialysis
Tidsramme: From the dialysis session start to the end of session at four hours (4h)
Zoledronic acid mass (mg)
From the dialysis session start to the end of session at four hours (4h)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Rodrigo B de Oliveira, PhD, University of Campinas

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

15. august 2026

Primær færdiggørelse (Anslået)

15. august 2027

Studieafslutning (Anslået)

15. august 2028

Datoer for studieregistrering

Først indsendt

16. juli 2026

Først indsendt, der opfyldte QC-kriterier

31. juli 2026

Først opslået (Faktiske)

3. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. september 2026

Sidst verificeret

1. september 2026

Mere information

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