Hemodialysis Vitamin D Pilot
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Purpose
Vitamin D is a prohormone obtained through diet, supplementation, or sun exposure. Once absorbed, this nutritional vitamin D undergoes a two-step reaction in the liver and in the kidney to become the active hormone, calcitriol. Besides the kidney, many other body tissues are capable of local vitamin D activation. This local tissue activity is important for maintenance of health and relies on adequate levels of nutritional vitamin D. Not only are dialysis patients deficient in calcitriol due to kidney failure, but they are also deficiency in nutritional vitamin D. Low levels of vitamin D have been associated with higher rates of death, heart and blood vessel disease, osteoporosis, falls, cancer, and autoimmune diseases. Despite this, there is a lack of randomized controlled trials (RCT) examining the effects of nutritional vitamin D in hemodialysis (HD) patients. The investigators hypothesize that long-term supplementation with nutritional vitamin D in HD patients improves survival and cardiovascular outcomes. Before embarking on a large scale RCT, the investigators propose a small pilot RCT with 20 hemodialysis patients to: i) To determine the effects of cholecalciferol (vitamin D3) in raising blood vitamin D levels; ii) To determine the feasibility and barriers to successful randomization and adherence to treatment protocols, which will inform subsequent studies.
| Condition | Intervention |
|---|---|
|
Vitamin D Deficiency Renal Failure Chronic Requiring Hemodialysis |
Drug: Cholecalciferol |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Oral Cholecalciferol (Vitamin D3) Therapy in Prevalent Hemodialysis Patients: A Randomized Placebo Controlled Pilot Study |
- Feasibility objectives for this proof-of-concept study [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- To determine the proportion of consecutive HD patients that are eligible, the proportion of eligible patients that will consent to randomization, and of those randomized, the proportion that will comply with their group assignment.
- To determine the treatment effect of oral cholecalciferol compared with placebo in raising serum 25(OH)D and 1,25(OH)2D levels in HD patients.
- Six Minute Walk Test [ Time Frame: 1 year ] [ Designated as safety issue: No ]1. To determine the proportion of eligible patients that are able to complete a baseline and end of study 6-minute walk test.
| Enrollment: | 20 |
| Study Start Date: | January 2011 |
| Study Completion Date: | June 2011 |
| Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Cholecalciferol
Cholecalciferol 50,000IU po once weekly for 12 continuous weeks.
|
Drug: Cholecalciferol
cholecalciferol 50,000 IU po once weekly for 12 weeks
Other Name: vitamin D3
|
|
Placebo Comparator: Placebo
Matching placebo po once weekly for 12 continuous weeks
|
Drug: Cholecalciferol
cholecalciferol 50,000 IU po once weekly for 12 weeks
Other Name: vitamin D3
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Participant is ≥ 18 years
Participant is on hemodialysis ≥ 3 months
Exclusion Criteria:
- Serum calcium >2.75 mmol/L
- On concurrent vitamin D treatment ≥ 800 IU/day. Includes ergocalciferol, cholecalciferol, calcedidiol, over-the-counter vitamin D. Does not include one-alpha calcidol (One Alfa®) or 1, 25 di-hydroxy-D3 (Rocaltrol® or Calcijex®)
- Known hypersensitivity or allergy to Vitamin D
- End stage liver disease
- Severe untreated malabsorption or resection of large segment of small bowel
- Lack of informed consent or inability to consent
- Currently enrolled in a RCT
Contacts and Locations| Canada, Ontario | |
| St. Joseph's Healthcare Hamilton | |
| Hamilton, Ontario, Canada, L8N 4A6 | |
| Principal Investigator: | Karen CY To, MD, FRCPC | St. Joseph's Health Care London |
| Principal Investigator: | Catherine Clase, FRCPC | St. Joseph's Health Care London |
| Principal Investigator: | Azim S Gangji, MD, FRCPC | St. Joseph's Health Care London |
More Information
No publications provided
| Responsible Party: | Dr. Catherine Clase, Nephrologist, Associate Professor, St. Joseph's Healthcare Hamilton, McMaster University |
| ClinicalTrials.gov Identifier: | NCT01214928 History of Changes |
| Other Study ID Numbers: | SJH PSI 001 |
| Study First Received: | August 30, 2010 |
| Last Updated: | July 19, 2011 |
| Health Authority: | Canada: Health Canada |
Keywords provided by St. Joseph's Healthcare Hamilton:
|
vitamin D cholecalciferol hemodialysis randomized controlled trial pilot |
Additional relevant MeSH terms:
|
Kidney Failure, Chronic Renal Insufficiency Vitamin D Deficiency Renal Insufficiency, Chronic Kidney Diseases Urologic Diseases Avitaminosis Deficiency Diseases Malnutrition Nutrition Disorders |
Cholecalciferol Vitamin D Ergocalciferols Vitamins Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions Bone Density Conservation Agents |
ClinicalTrials.gov processed this record on May 21, 2013