Aldosterone Blockade in Chronic Kidney Disease: Influence on Arterial Stiffness and Kidney Function (ALBLOCK-2)
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Purpose
Patients with Chronic Kidney Disease (CKD) have a poor prognosis primarily due to cardiovascular disease. The cardiovascular risk can be assessed by measurements of arterial stiffness. A decrease in stiffness has been shown to decrease the risk of cardiovascular disease as well as death. Most of the CKD population also have hypertension and the control of blood pressure is one of the corner stones in inhibition of disease progression. Using drugs that specifically block the renin-angiotensin-system for blood pressure control has been shown to have a beneficial impact on inhibition of progression beyond that of the achieved blood pressure control. It has been reported that inhibition of the hormone aldosterone has a positive effect on survival in patients with heart failure, hypertension and diabetic as well as on-diabetic nephropathy.
This study undertakes the investigation of the influence on arterial stiffness of adding an aldosterone receptor inhibitor to the medication CKD patients are already taking. Besides the primary end point which is Pulse wave velocity (PWV), arterial stiffness is also quantified thorough ambulatory blood pressure measurements.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Kidney Disease |
Drug: Eplerenone |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Aldosterone Blockade in Chronic Kidney Disease. Influence on Arterial Stiffness and Kidney Function |
- Pulse wave velocity [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]Pulse wave velocity measured using the SphygmoCor device.
- Pulse Wave velocity [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Pulse wave velocity [ Time Frame: baseline ] [ Designated as safety issue: No ]
- Ambulatory arterial stiffness index [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]24 hour ambulatory blood pressure measurements, give rise to the index, which is a secondary measure of arterial compliance.
- Pulse wave analysis [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]Parameters are Augmentation Index, subendocardial viability ratio, pulse, time to reflection, ejection duration.
- Albuminuria [ Time Frame: baseline ] [ Designated as safety issue: No ]Will be calculated from 24 hour urine collections.
- Pulse wave analysis [ Time Frame: baseline ] [ Designated as safety issue: No ]
- Ambulatory arterial stiffness index [ Time Frame: baseline ] [ Designated as safety issue: No ]
- Ambulatory arterial stiffness index [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Pulse wave analysis [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Albuminuria [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Albuminuria [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
- Estimated glomerular filtration rate (eGFR) [ Time Frame: baseline ] [ Designated as safety issue: Yes ]Estimated glomerular filtration rate (eGFR) will be calculated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.
- Estimated glomerular filtration rate (eGFR) [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
- Estimated glomerular filtration rate (eGFR) [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: baseline ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: week 1 ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: week 2 ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: week 4 ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: week 8 ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: week 12 ] [ Designated as safety issue: Yes ]
- Plasma potassium [ Time Frame: week 16 ] [ Designated as safety issue: Yes ]
- plasma potassium [ Time Frame: week 20 ] [ Designated as safety issue: Yes ]
- plasma potassium [ Time Frame: week 24 ] [ Designated as safety issue: Yes ]
- Blood pressure [ Time Frame: baseline ] [ Designated as safety issue: Yes ]BP will be measured at all visits
- Blood pressure [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
- Blood pressure [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
| Enrollment: | 54 |
| Study Start Date: | April 2010 |
| Study Completion Date: | February 2012 |
| Primary Completion Date: | January 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Treatment |
Drug: Eplerenone
25 mg once daily 1 week, then 50 mg once daily for another 23 weeks.
|
| No Intervention: Control |
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- ≥ 18 years age ≤ 80 years age
- voluntarily signed informed consent
- 15 ml/min/1,73 m2 ≤ estimated Glomerular Filtration Rate < 60 ml/min/1,73 m2
- BP ≥ 130/80 mmHg or undergoing anti-hypertensive treatment
Exclusion Criteria:
- p-potassium is > 5.0 mM
- allergy to contents
- treated with spironolactone
- treated with potent inhibitors of CYP3A4 (see SPC for details)
- treated with lithium, ciclosporin, tacrolimus, prednisolone, or other immunosuppressing drug
- inborn errors of metabolism (see SPC for details)
- pregnancy or lactation
- fertile woman, not using safe contraception devices
- dementia or other psychiatric disorder, making understanding of the study conditions impossible
- other severe, chronic illness besides CKD, including liver insufficiency, according to investigators' judgement
- vascular surgery including stenting or graft implantation on a. brachialis, aorta or the carotid arteries
- systolic BP > 200 mmHg
- immeasurable pulse amplitude
Contacts and Locations| Denmark | |
| Dept. Nephrology, Herlev Hospital | |
| Herlev, Denmark, DK-2730 | |
| Herlev Hospital | |
| Herlev, Denmark, DK-2730 | |
| Principal Investigator: | Lene Boesby, MD | Herlev Hospital |
More Information
No publications provided
| Responsible Party: | Lene Boesby, MD, Herlev Hospital |
| ClinicalTrials.gov Identifier: | NCT01100203 History of Changes |
| Other Study ID Numbers: | ALBLOCK-2 |
| Study First Received: | April 6, 2010 |
| Last Updated: | February 7, 2012 |
| Health Authority: | United States: Food and Drug Administration Denmark: Danish Dataprotection Agency Denmark: Danish Medicines Agency Denmark: Ethics Committee |
Keywords provided by Herlev Hospital:
|
aldosterone receptor inhibition arterial stiffness ambulatory arterial stiffness index |
Additional relevant MeSH terms:
|
Kidney Diseases Renal Insufficiency, Chronic Kidney Failure, Chronic Urologic Diseases Renal Insufficiency Eplerenone |
Aldosterone Antagonists Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013