The VALIDATE-D Study (VALIDATE-D)
Evaluating Hormonal Mechanisms for Vitamin D Receptor Agonist Therapy in Diabetes: The VALIDATE-D Study
調査の概要
詳細な説明
This study aims to evaluate whether vitamin D receptor agonist therapy (calcitriol) in diabetes lowers renin-angiotensin system (RAS) activity in a manner similar to an ACE inhibitor. This is a physiology study, focused on evaluating hormonal changes in the circulating and tissue RAS when compared to placebo.
Subjects with type 2 diabetes and obesity and normal kidney function will undergo evaluation of their circulating and renal-vascular RAS activity and urinary protein at baseline, after withdrawing interfering medications, while on a controlled electrolyte diet, and in controlled posture settings. They will then randomly receive a study medication (calcitriol or placebo) for 3 weeks followed by a re-assessment of their RAS parameters. The main outcomes that will be evaluated following calcitriol/placebo include measures of the circulating renin activity (primary), as well as measures of the renal-vascular RAS (renal plasma flow) and urine protein (secondary)
The primary outcome is the change in the plasma renin activity when sodium restricted, before and after intervention. Secondary outcomes include the change in renal plasma flow and urine protein when sodium loaded, before and after intervention.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Massachusetts
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Boston、Massachusetts、アメリカ、02115
- Brigham and Women's Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Type-Two Diabetes (treated with diet alone, with oral hypoglycemic agents, or with a single injection of basal insulin daily)
- Normal blood pressure, or Mild (Stage 1) Hypertension that is either untreated, or adequately treated with a single anti-hypertensive drug.
- Age >18 years and <70 years
- Estimated GFR > 60ml/min
- Normal laboratory values for: Complete blood count, sodium, potassium, glucose, liver enzymes, urinalysis
- Electrocardiogram without any signs of prior infarction, ventricular conduction abnormality, or supraventricular arrhythmia.
Exclusion Criteria:
- Chronic Kidney Disease or eGFR<60
- History of nephrolithiasis (kidney stones)
- Multiple (more than one) insulin injections daily (since insulin can alter the RAS)
- Poorly controlled type 2 diabetes (That may require more aggressive therapy) as defined by an HbA1c>8.5%
- Type 1 diabetes
- Stage 2 or Stage 3 hypertension or the use of more than 1 antihypertensive drug
- Chronic inflammatory conditions (such as inflammatory bowel disease or arthritis) that are treated with prescribed doses of NSAIDs by a physician.
- The use of prescribed doses of potassium supplements.
- History of liver failure
- History of parathyroid or granulomatous disorders
- History of heart failure, cerebrovascular disease or coronary heart disease
- History of known microvascular complications of diabetes (including retinopathy, neuropathy, nephropathy)
- Illness requiring overnight hospitalization in the past 6 months
- Active tobacco or recreational drug use
- Pregnancy or current breast feeding
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：防止
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：calcitriol
Subjects will receive calcitriol (titrated up to 0.75 mcg daily) for 3 weeks.
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Subjects will receive calcitriol (up to 0.75 mcg daily) for 3 weeks.
他の名前：
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プラセボコンパレーター：placebo
Subjects will receive placebo for 3 weeks.
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Subjects will receive placebo for 3 weeks.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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The Change in Circulating RAS Activity After Calcitriol/Placebo Therapy
時間枠：baseline and 2 weeks following calcitriol/placebo therapy
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The below results represent the change in Plasma Renin Activity.
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baseline and 2 weeks following calcitriol/placebo therapy
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in Renal Plasma Flow After Calcitriol/Placebo Therapy
時間枠：baseline and 3 weeks following calcitriol/placebo therapy
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Subjects had their renal plasma flow assessed at baseline while sodium loaded, and again after 3 weeks of randomized therapy with either calcitriol (up to 0.75 mcg daily) or placebo.
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baseline and 3 weeks following calcitriol/placebo therapy
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Change in Urine Protein After Calcitriol/Placebo Therapy
時間枠：baseline and 3 weeks following calcitriol/placebo therapy
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Subjects have their urine protein assessed at baseline while sodium loaded and again 3 weeks after randomized therapy with calcitriol or placebo.
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baseline and 3 weeks following calcitriol/placebo therapy
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 2012P000905
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