Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Phosphate Microvascular Study

23. august 2018 opdateret af: Veterans Medical Research Foundation

The Effects of Phosphate on Microvascular Function

Elevated phosphate concentrations in the blood have been associated with multiple negative health outcomes in patients with chronic kidney disease as well as in the general population. These negative outcomes include an increased risk of vascular complications like heart attack and stroke. While complications like heart attack and stroke reflect obstructive disease in large blood vessels, recent evidence suggests that elevated phosphate concentrations may first lead to disease in small blood vessels.

This single site clinical trial will randomize 20 veterans with end stage renal disease on hemodialysis to either a phosphate binder or placebo and evaluated for changes in their microvascular function using laser-Doppler flowmtery and nail-fold capillaroscopy.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Project Background: Recent studies have suggested that increased serum phosphate and phosphate intake may acute impair microvascular blood flow. However, this has never been directly tested using imaging techniques that directly measure microvascular flow. The end-stage renal disease population on hemodialysis at the VA San Diego is an ideal population to evaluate this effect.

Project Question: Does reduction of serum phosphate through the use of a phosphate binder (lanthanum carbonate) increase microvascular blood flow in persons with ESRD? Project Methods: The investigators propose a 4 week, randomized, double-blinded, placebo controlled, single-center, crossover trial. Participants will have their microvascular function assessed at the baseline of the study using laser-Doppler flowmetry and nail-fold capillaroscopy. They will then be randomized to either lanthanum carbonate or placebo for 2 weeks. Microvascular measurements will be repeated at the end of the 2 week period. Participants will then cross-over to the other study arm. After 2 weeks in the other study arm, they will have microvascular measurements repeated and the trial will then be complete. The primary outcome of the study will be the % change in skin blood flow after heating from 31 degrees Celsius to 44 degrees Celsius. This will be compared within each individual after they complete each arm of the study. Changes seen on nail-fold capillaroscopy, acceptability, safety, and adherence will be key secondary outcomes.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

20

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

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

21 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Diagnosis of ESRD on hemodialysis (HD) for >90 days.
  • Age >21.
  • Capacity to understand and sign informed consent as assess by principal investigator.
  • On a phosphate binder with stable dose for >2 weeks.
  • Serum phosphate at screening visit of <7.0.

Exclusion Criteria:

  • Pregnancy.
  • Actively breastfeeding.
  • Use of oral contraceptives.
  • Inability to take oral medications.
  • History of medication non-compliance as assessed by the treating physician.
  • Patients currently enrolled in another trial.
  • Planned or expected surgical procedure during study period.
  • Planned or expected hospitalization during study period.
  • Corrected serum calcium greater than 10.2 mg/dl.
  • Serum intact PTH >1000 pg/ml
  • Albumin < 3 g/dl.
  • Allergy or intolerance to lanthanum carbonate.
  • Principal investigator deems patient to be unsuitable.
  • Non-English speaking persons. (Study performed at VA, therefore do not anticipate this represents a significant portion of the population).

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Diagnostisk
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Ingen indgriben: Standard
Participants will have their hyperphosphatemia managed with lanthanum carbonate 1 g with meals and 500 mg with snacks as per typical care, for 2 weeks.
Placebo komparator: Intervention
Participants will take a placebo instead of standard care with a phosphate binder, for 2 weeks.
Andet: Withholding standard phosphate binder
In this trial, placebo represents the intervention and not the control. Standard therapy for hyperphosphatemia in end-stage renal disease includes treatment with a phosphate binder. In this trial the intervention will be to withhold the phosphate binder and use placebo instead. In this way the effect of a higher serum phosphate can be evaluated.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
% Change in flux of blood after skin heating to 44 C as measured using laser-Doppler flowmtery.
Tidsramme: Performed at initial study visit, at the end of the first arm of the study (Day 14) and again at the end of the second arm of the study (Day 28)
Flux of blood through skin will be measured using a Perimed PF5000. This will be performed at baseline in a temperature controlled room. Baseline skin measurements will be made at 31C. Skin will then be heated to 44 C. The percent change will be the outcome. This outcome will be compared within each person at the conclusion of each arm. Measurements will all be made on the Monday or Tuesday, the day of the participant's first dialysis treatment of the week. Measurements will be made prior to dialysis.
Performed at initial study visit, at the end of the first arm of the study (Day 14) and again at the end of the second arm of the study (Day 28)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in capillary count seen post occlusion from pre occlusion, as determined by nail-fold capillaroscopy.
Tidsramme: Performed at initial study visit, at the end of the first arm of the study (Day 14) and again at the end of the second arm of the study (Day 28)
Participants will undergo nail fold capillaroscopy using a CapiScope (KK Technology, Honiton United Kingdom) at baseline and then at the end of each treatment arm. Using a capillarascope a capillary count will be made. After measurement a BP cuff will be inflated to 200 mm Hg occlude flow to a single digit for 1 minute. 30 sec after release the count will be made again. This change will be compared within individuals between measurements made at the completion of each arm in the study. Measurements will all be made on the Monday or Tuesday, the day of the participant's first dialysis treatment of the week. Measurements will be made prior to dialysis. Values at the end of each treatment arm will be compared.
Performed at initial study visit, at the end of the first arm of the study (Day 14) and again at the end of the second arm of the study (Day 28)

Samarbejdspartnere og efterforskere

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

Sponsor

Veterans Medical Research Foundation

Samarbejdspartnere

San Diego Veterans Healthcare System

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

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 (Forventet)

1. januar 2019

Primær færdiggørelse (Forventet)

1. januar 2021

Studieafslutning (Forventet)

17. juli 2021

Datoer for studieregistrering

Først indsendt

9. juli 2018

Først indsendt, der opfyldte QC-kriterier

18. juli 2018

Først opslået (Faktiske)

20. juli 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. august 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. august 2018

Sidst verificeret

1. august 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • VAH170095

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

Ja

IPD-planbeskrivelse

de-identified data may be shared at end of study

IPD-deling Understøttende informationstype

  • Studieprotokol
  • Statistisk analyseplan (SAP)
  • Formular til informeret samtykke (ICF)

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ja

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Slutstadie nyresygdom

Kliniske forsøg med Withholding standard phosphate binder

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Greece

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner