The Measurement of Insulin Resistance in Peritoneal Dialysis Patients
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Purpose
The goal of this study is to examine the relevance of insulin resistance in peritoneal dialysis (PD) patients as well as the means to improve this metabolic derangement. We will do so through a prospective randomized study using Icodextrin as an alternate dialysate solution to routine glucose-based dialysate. We hypothesize that (1) the glucose loading associated with PD leads to impairment in insulin sensitivity, (2) the degree of insulin resistance is dependent on the basal metabolic state (fasting versus stimulated), and (3) the replacement of conventional dialysate with glucose-sparing dialysate preparations will improve insulin resistance and associated metabolic disturbances in PD patients.
| Condition | Intervention |
|---|---|
|
End Stage Renal Disease |
Other: Icodextrin dialysate |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | The Measurement of Insulin Resistance in Peritoneal Dialysis Patients |
- improvement in glucose disposal rate [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- the Pearson or Spearman correlation coefficient values between IR measured by insulin clamp study and other methods (e.g., HOMA, QUICKI, OGTT) [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 12 |
| Study Start Date: | September 2010 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: glucose-based dialysate
most frequently used SOC dialysate
|
|
|
Icodextrin dialysate
alternate SOC dialysate
|
Other: Icodextrin dialysate
use of alternate SOC dialysate
|
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Medically stable and receiving stable PD for ≥ 3 months;
- BMI ≤ 45;
- Most recent Kt/V ≥1.7 or Tccr ≥ 50l/week/1.73m2;
- On Glucose lactate-buffered PD solutions with consistent glucose exposure.
Exclusion Criteria:
- Pregnancy or breast-feeding;
- Intolerance to the study protocols;
- Severe, unstable, active, or chronic inflammation disease (active infection, active connective tissue disorder, active cancer, HIV, liver disease);
- Chronic use of anti-inflammatory medication except low dose (< 10mg/d) prednisone;
- Severe hypokalemia (K+ level < 3.0 mEq/L);
- Hypercalcemia (Ca++ level > 11.0 mg/dL);
- Have a glycogen storage disease;
- Intolerant to maltose or isomaltose;
- Allergic to cornstarch or icodextrin;
- Recent abdominal surgery in the past 30 days;
- Chronic Obstructive Lung Disease (COPD) or Interstitial lung disease;
- Insulin-Dependent Diabetes Mellitus (IDDM).
Contacts and Locations| Contact: Cindy Booker, LPN | 615-343-5828 | cindy.a.booker@vanderbilt.edu |
| United States, Tennessee | |
| Vanderbilt University Medical Center | Recruiting |
| Nashville, Tennessee, United States, 37232 | |
| Contact: Cindy Booker, LPN 615-322-4698 cindy.a.booker@vanderbilt.edu | |
| Principal Investigator: Alp Ikizler, MD | |
| Principal Investigator: | Alp Ikizler, MD | Vanderbilt University |
More Information
No publications provided
| Responsible Party: | Alp Ikizler, Professor, Vanderbilt University |
| ClinicalTrials.gov Identifier: | NCT01119196 History of Changes |
| Other Study ID Numbers: | 100177 |
| Study First Received: | May 5, 2010 |
| Last Updated: | January 21, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Vanderbilt University:
|
Peritoneal Dialysis Insulin resistance |
Additional relevant MeSH terms:
|
Insulin Resistance Kidney Diseases Kidney Failure, Chronic Hyperinsulinism Glucose Metabolism Disorders Metabolic Diseases Urologic Diseases |
Renal Insufficiency, Chronic Renal Insufficiency Insulin Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013