Renal Denervation in Diabetic Nephropathy (DERENEDIAB)
Renal Denervation in Patients With Diabetic Nephropathy and Persistent Proteinuria
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Phase 4
Kontakte und Standorte
Studienorte
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Paris, Frankreich, 75015
- CIC Hopital europeen george pompidou
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Type 2 diabetes mellitus male or female patient
- Individual is > 18 and ≤ 75 years old
- Diabetic nephropathy (if no pathological examination, diagnosis based on the association of history of diabetes, diabetic retinopathy and no hematuria)
- Proteinuria/creatininuria ratio > 0.1 g/mmol lasting for 8 weeks
- Under stable medication regimen including for at least 2 months full tolerated doses of al least 1 RAAS blocker (ACEI, renin inhibitor, ARB) and a diuretic
- 2 functional kidneys sizing ≥ 90 mm; eGFR > 20 mL/min/1.73m² (MDRD formula
- Suitable aorto-renal vascular anatomy compatible with the endovascular denervation procedure; Informed consent has been signed
- Health insurance policy active
Exclusion Criteria:
- Patients with an estimated glomerular filtration rate (eGFR) of less than 20 mL/min/1.73 m2
- Patients unable to sign an informed consent, to understand the protocol, living too far from the specialized center
- Non-diabetic renal disease
- Patients with severe hypertension (grade 3 ESH classification)
- Kaliemia ≥ 6mmol/L
- History of nephrogenic fibrosis-induced MRI contrast media
- Patient with single functioning kidney
- Patient with contrast media allergy
- Patient with any implantable device incompatible with low frequency waves delivery
- Patient with contra-indication to the anti-proteinuric standardized medication regimen
- Patient with transient or fixed cerebral ischemia within 3 months before inclusion
- Patient with myocardial infarction, unstable angina pectoris, coronary bypass or percutaneous angioplasty within 3 months before inclusion
- Patient with asthma or chronic obstructive pulmonary disease with a contra-indication to beta-blockers medication
- Patient with type 1 diabetes mellitus
- Uncontrolled type 2 diabetes mellitus (Hb1Ac > 10%)
- Patient with malignancy within the 5 past years
- Patient with any medical or surgical condition that could worsen the risk of the study, according to the investigator; Patient with chronic alcohol consumption
- Patient with atrial fibrillation and/or a brachial circumference of ≥ 42cm
- Patient is pregnant, nursing or planning to be pregnant
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Experimental: Denervation + TMNS
Patients are treated with the renal denervation procedure after randomization and are maintained on standardized anti-proteinuric medications
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Patients are treated with the renal denervation procedure after randomization and are maintained on standardized anti-proteinuric medications
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Aktiver Komparator: TMNS
Patients are maintained on standardized anti-proteinuric medications
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Patients are maintained on Standardized antiproteinuric medication regimen includes an angiotensin receptor blocker (irbesartan 300mg), a diuretic (furosemide 40mg or indapamide LP 1.5mg according to the eGFR), 25OH vitamin D3 and a statin (atorvastatin 20mg)
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
|---|---|
|
proteinuria/creatininuria ratio
Zeitfenster: from baseline to 1 year
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from baseline to 1 year
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Number of patients with a decrease of the PU/CrU >50% ratio
Zeitfenster: from baseline to 1 year
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from baseline to 1 year
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Evaluation of the slope of decay of the PU/CrU
Zeitfenster: from baseline to 1 year
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from baseline to 1 year
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eGFR is estimated by the MDRD formula, and is expressed in mL/min/1.73m². The direct GFR will be assessed by measuring the 51Cr-EDTA plasmatic clearance
Zeitfenster: from baseline to 1 year
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eGFR is estimated by the MDRD formula, and is expressed in mL/min/1.73m².
The direct GFR will be assessed by measuring the 51Cr-EDTA plasmatic clearance
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from baseline to 1 year
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Outcome of the GFR assessed by 51Cr-EDTA clearance
Zeitfenster: from randomisation to 1 year
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Only in the experimental arm
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from randomisation to 1 year
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Decrease of the blood pressure assessed on ABPM
Zeitfenster: From randomisation to 1 year
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From randomisation to 1 year
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Anti-hypertensive regimen score
Zeitfenster: from baseline to 1 year
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from baseline to 1 year
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Evaluation of the renal arterial anatomy
Zeitfenster: from baseline to 1 year
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in the experimental group:number of principal renal artery.
Should be 1/ kidney of at least 4mm diameter and 10mm long.
One accessory artery is acceptable if <
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from baseline to 1 year
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Evaluation of safety and tolerance of renal denervation in diabetic patients with overt proteinuria
Zeitfenster: from baseline to 1 year
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in the experimental group:Occurrence of adverse events: acute renal failure, damage on the renal artery (dissection, perforation, thrombosis), allergy to the contrast media, worsening of any dysautonomia
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from baseline to 1 year
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Evaluate the outcome of biological parameters
Zeitfenster: from baseline to 1 year
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eGFR (MDRD formula), proteinuria/creatininuria ratio
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from baseline to 1 year
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Evaluate the diabetic neuropathy/dysautonomy
Zeitfenster: from randomisation to 1 year
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in the experimental:blood pressure in orthostatism, pulse wave velocimetry, RR interval on the Holter ECG, cutaneous baroreflex
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from randomisation to 1 year
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Evaluate the outcome of specific kidney injury markers
Zeitfenster: from randomisation to 1 year
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in the experimental group:urinary levels of KIM1 and NGAL before and 1 year after the denervation
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from randomisation to 1 year
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Guillaume Bobrie, MD, HTA department
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Störungen des Glukosestoffwechsels
- Stoffwechselerkrankungen
- Urologische Erkrankungen
- Urologische Manifestationen
- Erkrankungen des endokrinen Systems
- Diabetes-Komplikationen
- Diabetes Mellitus
- Störungen beim Wasserlassen
- Diabetes mellitus, Typ 2
- Nierenerkrankungen
- Diabetische Nephropathien
- Proteinurie
- Physiologische Wirkungen von Arzneimitteln
- Molekulare Mechanismen der pharmakologischen Wirkung
- Natriuretische Mittel
- Mikronährstoffe
- Vitamine
- Mittel zur Erhaltung der Knochendichte
- Calciumregulierende Hormone und Wirkstoffe
- Vitamin-D
- Cholecalciferol
- Diuretika
- Angiotensin-Rezeptor-Antagonisten
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- P110122
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