Ignite Creation Date:
2025-12-24 @ 11:24 PM
Ignite Modification Date:
2026-01-03 @ 11:06 PM
Study NCT ID:
NCT02684656
Status:
COMPLETED
Last Update Posted:
2019-12-24
First Post:
2016-02-09
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Reduction of Oxalate and Inflammation by Hemodiafiltration vs. Hemodialysis
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D007249', 'term': 'Inflammation'}], 'ancestors': [{'id': 'D010335', 'term': 'Pathologic Processes'}, {'id': 'D013568', 'term': 'Pathological Conditions, Signs and Symptoms'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'D006435', 'term': 'Renal Dialysis'}, {'id': 'D017583', 'term': 'Hemodiafiltration'}], 'ancestors': [{'id': 'D017582', 'term': 'Renal Replacement Therapy'}, {'id': 'D013812', 'term': 'Therapeutics'}, {'id': 'D016060', 'term': 'Sorption Detoxification'}, {'id': 'D006440', 'term': 'Hemofiltration'}, {'id': 'D005112', 'term': 'Extracorporeal Circulation'}, {'id': 'D013514', 'term': 'Surgical Procedures, Operative'}]}}, 'protocolSection': {'designModule': {'phases': ['NA'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'NON_RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'DIAGNOSTIC', 'interventionModel': 'CROSSOVER'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 14}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2016-02', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2019-12', 'completionDateStruct': {'date': '2016-09', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2019-12-20', 'studyFirstSubmitDate': '2016-02-09', 'studyFirstSubmitQcDate': '2016-02-12', 'lastUpdatePostDateStruct': {'date': '2019-12-24', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2016-02-18', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2016-09', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Plasma oxalate', 'timeFrame': '6 months'}], 'secondaryOutcomes': [{'measure': 'Cytokines measured by multiplex analysis', 'timeFrame': '6 months'}]}, 'oversightModule': {'oversightHasDmc': False}, 'conditionsModule': {'keywords': ['Oxalate', 'Inflammation', 'Hemodiafiltration', 'Hemodialysis', 'Oxalate Blood Sample'], 'conditions': ['Chronic Kidney Disease Requiring Chronic Dialysis']}, 'referencesModule': {'references': [{'pmid': '10411702', 'type': 'BACKGROUND', 'citation': 'Hoppe B, Kemper MJ, Bokenkamp A, Portale AA, Cohn RA, Langman CB. Plasma calcium oxalate supersaturation in children with primary hyperoxaluria and end-stage renal failure. Kidney Int. 1999 Jul;56(1):268-74. doi: 10.1046/j.1523-1755.1999.00546.x.'}, {'pmid': '23739234', 'type': 'BACKGROUND', 'citation': 'Knauf F, Asplin JR, Granja I, Schmidt IM, Moeckel GW, David RJ, Flavell RA, Aronson PS. NALP3-mediated inflammation is a principal cause of progressive renal failure in oxalate nephropathy. Kidney Int. 2013 Nov;84(5):895-901. doi: 10.1038/ki.2013.207. Epub 2013 Jun 5.'}]}, 'descriptionModule': {'briefSummary': 'The health care burden of CKD is substantial and growing with 10-15% of the population affected in both developed and developing countries. It is well established that CKD is associated with systemic inflammation, which promotes cardiovascular disease and body wasting. However, causal therapies to treat systemic inflammation, and treat its adverse consequences remain sparse. As kidney function declines in all forms of CKD, oxalate levels increase in the plasma, leading to increased systemic exposure to oxalate and consequent tissue injury. Work from the investigators has shown that elevated plasma oxalate levels activate the NLRP3 inflammasome which in turn leads to the processing and release of cytokines. The investigators seek to test the hypothesis that oxalate contributes to the systemic inflammation observed in patients with end-stage renal disease (ESRD). The investigators plan to define the association between plasma oxalate levels and signs of systemic inflammation in patients on hemodialysis. In a second step the investigators will examine whether hemodiafiltration lowers plasma oxalate more efficiently than hemodialysis and reduces signs of systemic inflammation. Confirmation of the hypothesis may lead to the identification of oxalate as a novel therapeutic target for interventional trials aimed at reducing plasma oxalate in patients with ESRD.', 'detailedDescription': 'The positive interaction between diffusive and convective flux has suggested that hemodiafiltration (HDF) has a higher oxalate extraction rate as compared with hemodialysis (HD). However, it has not been evaluated whether HDF can lower predialysis oxalate levels below the level of supersaturation. By using an intra-individual approach with the inclusion/exclusion criteria listed for the study, we plan to determine plasma oxalate and cytokine levels in 20 patients (10 on regular duration HD, 10 patients on extended duration HD) before dialysis. Subsequently, patients will be switched to HDF and plasma oxalate concentration and cytokines will be analyzed again two weeks following HDF treatment. Plasma oxalate (Pox) will be measured at beginning of treatment, mid, end and 2 hrs post treatment (to determine rebound) in order to provide oxalate kinetics on HD/HDF treatment. Cytokines will only be measured pre HD/HDF treatment to assess steady state inflammation.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['CHILD', 'ADULT', 'OLDER_ADULT'], 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Blood Flow ≥ 250 ml/min\n* Dialysate Flow ≥ 500 ml/min\n* Urinary Excretion \\< 400 ml/24h\n* Duration of Dialysis ≥ 4h\n* On HDF/HD treatment for ≥ 4 weeks\n* Extended HDF/HD for ≥ 4 weeks\n\nExclusion Criteria:\n\n* Recirculation (online measurement) \\> 15%\n* Single needle dialysis or single lumen catheter\n* Substitution volume of \\< 20l on HDF'}, 'identificationModule': {'nctId': 'NCT02684656', 'briefTitle': 'Reduction of Oxalate and Inflammation by Hemodiafiltration vs. Hemodialysis', 'organization': {'class': 'OTHER', 'fullName': 'University of Erlangen-Nürnberg Medical School'}, 'officialTitle': 'Pilot Study of Lowering Plasma Oxalate With Hemodiafiltration to Reduce Systemic Inflammation in Patients With End-Stage Renal Disease (ESRD)', 'orgStudyIdInfo': {'id': 'UErlangen-Nurnberg'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'ACTIVE_COMPARATOR', 'label': 'Hemodialysis', 'description': 'Intervention: Patients will be switch to hemodialysis and basal plasma oxalate levels as well as oxalate removal by hemodialysis will be determined after two weeks of treatment.', 'interventionNames': ['Procedure: Hemodialysis']}, {'type': 'ACTIVE_COMPARATOR', 'label': 'Hemodiafiltration', 'description': 'Intervention: Patients will be switch back to hemodiafiltration and basal plasma oxalate levels as well as oxalate removal by hemodiafiltration will be determined after two weeks of treatment.', 'interventionNames': ['Procedure: Hemodiafiltration']}], 'interventions': [{'name': 'Hemodialysis', 'type': 'PROCEDURE', 'description': 'Hemodialysis \\>/=4h', 'armGroupLabels': ['Hemodialysis']}, {'name': 'Hemodiafiltration', 'type': 'PROCEDURE', 'description': 'Hemodiafiltration \\>/=4h, \\> 20l convection', 'armGroupLabels': ['Hemodiafiltration']}]}, 'contactsLocationsModule': {'locations': [{'zip': '91054', 'city': 'Erlangen', 'state': 'Bavaria', 'country': 'Germany', 'facility': 'Nephrology Department, University Hospital Erlangen', 'geoPoint': {'lat': 49.59099, 'lon': 11.00783}}], 'overallOfficials': [{'name': 'Felix Knauf, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'University Erlangen-Nuremberg, Germany'}, {'name': 'Kai-Uwe Eckardt, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'University Erlangen-Nuremberg, Germany'}, {'name': 'Fred Finkelstein, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'Medical Director of New Haven Home Dialysis'}, {'name': 'Peter S Aronson, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'Yale University New Haven, USA'}, {'name': 'Chirag Parikh, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'Yale University New Haven'}, {'name': 'Mark A Perazella, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'Yale University New Haven'}]}, 'ipdSharingStatementModule': {'ipdSharing': 'NO'}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'University of Erlangen-Nürnberg Medical School', 'class': 'OTHER'}, 'collaborators': [{'name': 'Renal Research Institute', 'class': 'OTHER'}], 'responsibleParty': {'type': 'SPONSOR'}}}}