- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00581269
Dietary Intervention and Exercise Training (DIET) in Moderate to Severe Chronic Kidney Disease
The oxidative stress and inflammatory state is known to contribute to the pathogenesis of atherosclerosis, and is predictive of cardiovascular events and mortality rates in the general population and patients with chronic kidney disease (CKD), particularly in patients with end stage renal disease (ESRD) on dialysis therapy 1. Increased oxidative stress and inflammation has been identified in all stages of CKD, ranging from moderate renal insufficiency to ESRD. However, the pathophysiology of increased oxidative stress and inflammation associated with the development of CKD is currently poorly understood.
There is also concern about the epidemic of obesity in the United States, as the overall health status of the general population is adversely affected by increasing adiposity. Recent studies indicate a strong relationship between adiposity and incident CKD. Furthermore, the presence of an elevated body mass index (BMI) is an independent predictor for progression to ESRD, even after additional adjustments for baseline blood pressure and the presence or absence of diabetes mellitus. Limited data in the general population show that healthy lifestyle interventions, such as exercise and dietary caloric restriction, either alone or in combination, reduce the inflammatory and oxidative stress burden seen in obese subjects. The impact of healthy lifestyle modifications on inflammation and oxidative stress has not been investigated in the obese CKD population. Based on the foregoing observations, the purpose of this investigation will be to determine whether healthy lifestyle interventions in the form of low-impact aerobic exercise and dietary calorie restriction in obese subjects (BMI ≥ 30kg/m2) with moderate to severe (Stage III-IV) CKD [estimated glomerular filtration rate (GFR) 20-59 ml/min] will improve oxidative stress, inflammation, insulin resistance, adipocytokines, endothelial dysfunction, and quality of life.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 2
Contactos y Ubicaciones
Ubicaciones de estudio
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-
Tennessee
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Nashville, Tennessee, Estados Unidos, 37232
- Vanderbilt University Medical Center
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-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Patients with Stage III-IV (estimated GFR 20-59 min/ml) chronic kidney disease measured by MDRD formula.
- BMI ≥ 30 kg/m2
- Age > 18 or < 65 years.
- Life expectancy greater than one year.
- Ability to understand and provide informed consent for participation in the study.
Exclusion Criteria:
- Active inflammatory disease such as: AIDS (HIV seropositivity is not an exclusion criteria), active hepatitis C or B, active gout, other active inflammatory diseases.
- Active malignancy excluding basal or squamous cell carcinoma of the skin.
- Patients suffering from Type I Diabetes Mellitus
- Patients with reduced daily caloric intake at baseline (≤ 2000 kcal/day) or malnutrition.
- Patients who are already on a consistent and rigorous exercise regimen.
- Gastrointestinal dysfunction requiring parental nutrition.
- History of functional kidney transplant < 6 months prior to study entry.
- Anticipated live donor kidney transplant over study duration.
- Patients taking anti-inflammatory medication except aspirin < 325mg/day over the past 30 days.
- Patients taking Vitamin E supplements > 60 IU/day, vitamin C > 500mg/day over the past 30days.
- Patients taking any prednisone therapy.
- Hospital admission within the last 30 days.
- On experimental drug protocols.
- Significant cardiac or vascular disease (symptomatic disease; CV event(s) within the last year; significant occlusive atherosclerotic disease or ischemic disease on non-invasive or invasive diagnostic procedures).
- Significant physical disability or immobility (joint disease, joint replacement, muscular disorders).
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Comparador activo: 1
low-impact aerobic exercise group
|
subjects will undergo supervised physical activity for a maximum of 30-60 minutes, every other day, 3 days per week for 3 months; to offer variety in the exercise prescription, subjects will alternately use a treadmill, an elliptical trainer, a Nu-Step cross-trainer and a recumbent stationary bicycle
|
Comparador activo: 2
dietary restriction group
|
subjects will undergo a 20% reduction in total daily calories from their usual daily energy consumption every day for 3 months
|
Sin intervención: 3
control group
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
---|---|
a statistically significant decrease in plasma F2-isoprostanes, a specific oxidative stress marker
Periodo de tiempo: 3 months
|
3 months
|
a statistically significant decrease in hs-CRP, a specific inflammatory marker
Periodo de tiempo: 3 months
|
3 months
|
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
---|---|
significant changes in additional markers of oxidative stress and inflammation
Periodo de tiempo: 3 months
|
3 months
|
significant changes in insulin resistance and adipocytokines
Periodo de tiempo: 3 months
|
3 months
|
a significant improvement in endothelial function as measured by brachial artery FMD
Periodo de tiempo: 3 months
|
3 months
|
a significant improvement in quality of life scores
Periodo de tiempo: 3 months
|
3 months
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Alp Ikizler, MD, Vanderbilt University Medical Center
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 070990
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