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Intermittent Low Energy Diet in CKD: MIX UP Feasibility Study (MIX-UP)

4 de septiembre de 2020 actualizado por: King's College Hospital NHS Trust

Model of Intermittent Very Low Energy Diet and eXercise for Lowering BMI in Patients With CKD (MIX UP): Feasibility Study

This study proposes to investigate the acceptability and efficacy of intermittent VLED (5:2 diet) plus exercise, compared with the investigator's established Weight Management Programme (WMP), in obese patients with CKD, using feasibility study methodology.

Patients will be invited to participate in the parallel arm, single blinded, randomised controlled feasibility study, and randomly allocated to 1 of 2 treatments for 6 months. The experimental arm involves an intermittent modified fasting regimen consisting of VLED (600 kcal/day) on 2 consecutive days, and 5 days each week on a modified diet to maintain an overall energy deficit of 600 kcal/day across the week (5:2 diet). The control arm will be the standard renal WMP with a continuous energy restricted diet aimed at reducing daily energy intake by 600 kcal/day.

The feasibility outcomes are: recruitment rate >50%; intervention retention rate at 6 months >60%; dietary intervention compliance; and weight loss. Secondary outcomes include safety, body composition, proteinuria, lipids, blood pressure, and eating desire. Measurements will be made at baseline, midpoint, and twice at endpoint.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Actual)

13

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Reino Unido
      • London, Reino Unido, SE5 9RS
        • King's College Hospital

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 75 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • aged 18-75 years
  • KDIGO defined CKD (all categories)
  • BMI ≥30kg/m2
  • able to provide written informed consent in English

Exclusion Criteria:

  • pregnant or breastfeeding women
  • conservatively managed CKD stage 5
  • palliative or active treatment for cancer
  • unstable chronic liver disease
  • type 1 diabetes and type 2 diabetes controlled with anti-hyperglycaemic medication
  • previous bariatric surgery
  • unable to provide written informed consent
  • significant psychiatric disorder or uncontrolled depression
  • participated in a weight management drug trial in the previous 3 months
  • uncontrolled epilepsy
  • alcohol or substance abuse

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Intervention
The intervention arm will involve standard care plus an intermittent modified fasting regimen consisting of a very low energy diet (600 kcal/day) on 2 consecutive days of the week, and 5 days each week on an energy restricted diet to maintain a similar overall energy deficit of 600 kcal/day across the week (5:2 diet). All dietary intake on modified fasting days will be from LighterLife foodpacks, (4 x 150 kcal portions/day presented as milkshakes, cereal bars, soups and modified meals such as spaghetti bolognese, or macaroni cheese) providing ~600 kcal/day and 100% of the RNI for vitamins and minerals.
Conductual: 5:2 diet
very low energy diet (600 kcal/day) on 2 consecutive days of the week, and 5 days each week on an energy restricted diet to maintain a similar overall energy deficit of 600 kcal/day across the week (5:2 diet)
Conductual: Renal Weight Management Programme
Dietary intervention includes a standard continuous energy restricted diet aimed at reducing daily energy intake by 600 kcal/day relative to their estimated total energy expenditure. In addition to the dietary intervention, the programme also includes personal exercise plans, optional pharmacotherapy (orlistat at standard dose), and development of personalised dietary and exercise goals using behavioural therapy techniques and motivational interviewing.
Comparador activo: Standard Care
Renal Weight management Programme - Patients will attend individual appointments with the specialist dietitian and physiotherapist once a month, for 6 months. Dietary intervention includes a standard continuous energy restricted diet aimed at reducing daily energy intake by 600 kcal/day relative to their estimated total energy expenditure (9). In addition to the dietary intervention, the programme also includes personal exercise plans, optional pharmacotherapy (orlistat at standard dose), and development of personalised dietary and exercise goals using behavioural therapy techniques and motivational interviewing.
Conductual: Renal Weight Management Programme
Dietary intervention includes a standard continuous energy restricted diet aimed at reducing daily energy intake by 600 kcal/day relative to their estimated total energy expenditure. In addition to the dietary intervention, the programme also includes personal exercise plans, optional pharmacotherapy (orlistat at standard dose), and development of personalised dietary and exercise goals using behavioural therapy techniques and motivational interviewing.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Retention rate of at least 60% in the intervention group
Periodo de tiempo: 6 months
Patients attending at least 80% of monthly clinic visits, including the baseline and final study visits, and remaining compliant with the 2 consecutive days VLED throughout the 6 month intervention will be considered "completers" and count as being retained in the intervention group at 6 months.
6 months
Number of Adverse Events following intermittent very low energy diet
Periodo de tiempo: 6 months
record of all adverse events including but not limited to nausea, constipation and/or diarrhoea, dehydration, hypoglycaemia, lethargy & fatigue, headaches, gallstones and gout.
6 months

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Recruitment rate of at least 50% of potential participants meeting inclusion and exclusion criteria
Periodo de tiempo: 1 year
at least 50% of those meeting the referral criteria and are approached to participant, consent to participating in the study
1 year
Compliance with dietary intervention from dietary records
Periodo de tiempo: 6 months
at least 70% compliance with prescribed diet
6 months
Weight change (kg)
Periodo de tiempo: 6 months
change in weight from baseline to 6 months
6 months
kidney function (eGFR ml/min CKD EPI equation)
Periodo de tiempo: 6 months
monitoring if estimated kidney function declines during the study or if symptomatic for dehydration.
6 months
Waist circumference (cm)
Periodo de tiempo: 6 months
change in waist circumference measured in cm at level of umbilicus
6 months
Body composition
Periodo de tiempo: 6 months
lean and fat mass (kg) estimated by bioelectrical impedance analysis
6 months
Exercise capacity - 6 minute timed walk test
Periodo de tiempo: 6 months
distance walked (m) in 6 minutes
6 months
Exercise capacity - sit to stand 60
Periodo de tiempo: 6 months
number (count) of sit to stand movements in 60 seconds
6 months
Proteinuria
Periodo de tiempo: 6 months
urinary protein to creatinine ratio
6 months
Total Cholesterol
Periodo de tiempo: 6 months
plasma total cholesterol concentration
6 months
Triglycerides
Periodo de tiempo: 6 months
plasma triglycerides concentration
6 months
LDL cholesterol
Periodo de tiempo: 6 months
plasma LDL cholesterol concentration
6 months
HDL cholesterol
Periodo de tiempo: 6 months
plasma HDL cholesterol concentration
6 months

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

King's College Hospital NHS Trust

Investigadores

  • Investigador principal: Helen L MacLaughlin, PhD, King's College Hospital NHS Fundation Trust

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

25 de octubre de 2017

Finalización primaria (Actual)

31 de diciembre de 2018

Finalización del estudio (Actual)

6 de junio de 2019

Fechas de registro del estudio

Enviado por primera vez

1 de agosto de 2018

Primero enviado que cumplió con los criterios de control de calidad

7 de noviembre de 2018

Publicado por primera vez (Actual)

9 de noviembre de 2018

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

7 de septiembre de 2020

Última actualización enviada que cumplió con los criterios de control de calidad

4 de septiembre de 2020

Última verificación

1 de julio de 2018

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • KCH17-027
  • 202350 (Identificador de registro: IRAS)

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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