Peroral Supplemental Nutrition in End-stage Renal Disease With and Without HIV Comorbidity - Full Text View

Purpose

End-stage renal disease is often accompanied by malnutrition due to less appetite, metabolic changes or both. Human immunodeficiency virus-infection may exacerbate the state of malnutrition. In a pilot study, we recruit both HIV invected and non-infected patients on hemodialysis. Non-HIV patients will be randomized to peroral supplemental nutrition or no peroral supplemental nutrition. All HIV patients will receive peroral supplemental nutrition. The nutritional state will be determined in magnet resonance tomography at the start and at the end of the study (muscle diameter of triceps m.) and with laboratory parameters (plasma albumin and others). The hypothesis is that supplemental peroral nutrition (a total 250 kcal per day) will stop loss of muscle mass in end-stage renal disease patients (compared to their counterparts without supplemental peroral nutrition) as well as in the high risk group of HIV patients. This pilot study may lead to larger randomized clinical trials and, may affect dietary recommendations.

Condition	Intervention
End-Stage Renal Disease	Dietary Supplement: peroral high-caloric supplemental nutrition Dietary Supplement: peroral supplemental nutrition

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention
Official Title:	MRT-based Pilot Study to Evaluate Peroral Supplemental Nutrition for Prevention of Cachexia in End-stage Renal Disease With and Without HIV Comorbidity

Resource links provided by NLM:

MedlinePlus related topics: Dialysis Dietary Supplements HIV/AIDS Kidney Failure

U.S. FDA Resources

Further study details as provided by Johann Wolfgang Goethe University Hospitals:

Primary Outcome Measures:

Cross sectional area of triceps m. in mid-humerus position (MRT) [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

plasma albumin < 3.6 mg/dl [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Estimated Enrollment:	30
Study Start Date:	May 2008
Study Completion Date:	May 2010
Primary Completion Date:	September 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: 1 HIV-positive hemodialysis patients (as a high risk group for cachexia) will be given daily drinks of Renilon 7.5 (125 ml, 2 kcal/ml) as peroral supplemental nutrition on top to their recommended high-protein, high-caloric diet.	Dietary Supplement: peroral high-caloric supplemental nutrition HIV-positive hemodialysis patients will be given daily supplemental nutrition (125 ml, 2 kcal/ml) on top of recommended high-protein, high-caloric regular diet Other Name: Renilon 7.5 by Pfrimmer Nutricia
No Intervention: 2 Chronic hemodialysis patients randomized to no peroral supplemental nutrition
Active Comparator: 3 Chronic hemodialysis patients randomized to peroral supplemental nutrition.	Dietary Supplement: peroral supplemental nutrition Chronic hemodialysis patients will be given daily peroral supplemental nutrition (125 ml/d, 2 kcal/ml) on top of their recommended high-protein, high caloric diet Other Name: Renilon 7.5 by Pfrimmer-Nutricia

Detailed Description:

In end-stage renal disease (ESRD), cachexia is a common finding. Metabolic changes, malnutrition, or both appear to be the underlying problems. In fact, lean body mass per body weight better predicts prognosis than creatinin based models (NDT, 2004.19:1182). In addition, comorbidity such as HIV infection may exacerbate cachexia found in ESRD. Whether or not daily supplemental, high-caloric nutrition in ESRD corrects a catabolic state in ESRD is unclear.

Hypothesis to be tested:

Daily supplemental high-caloric nutrition beneficially affects cytokine stimulation (TNF alpha, IL 1beta, IL 6, CrP) and nutritional state (cross sectional area of triceps m. in mid-humerus position (MRT), plasma albumin) in in HIV-positive hemodialysis patients and in chronic hemodialysis patients compared to chronic hemodialysis patients without supplemental nutrition.

Eligibility

Ages Eligible for Study:	18 Years to 75 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

patients on hemodialysis for more than 1 year,
Group 1: HIV infection

Exclusion Criteria:

patients on hemodialysis for less than 1 year,
Group 2 and 3: HIV infection
no pre-/post dialysis weight differences of > 3 kg after long HD free interval over last 10 HD sessions.
no current high-caloric nutrition supplements or planned high-caloric supplements for clinical reasons.
pregnancy
for women: no use of oral contraceptives or other at least equally effective contraception in women with childbearing potential
known neoplastic disease other than skin tumors (except melanoma)
mental disease or retardation with impaired judgement power

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00687050

Locations

Germany
Hospital of the Goethe University Frankfurt am Main
Frankfurt am Main, Germany, 60590

Sponsors and Collaborators

Johann Wolfgang Goethe University Hospitals

Pfrimmer Nutricia GmbH, Erlangen , Germany

More Information

No publications provided

Responsible Party:	Dr. Rainer U. Pliquett, Goethe University Frankfurt am Main
ClinicalTrials.gov Identifier:	NCT00687050 History of Changes
Other Study ID Numbers:	Goethe-Uni-FFM-328-07
Study First Received:	May 27, 2008
Last Updated:	May 25, 2010
Health Authority:	Germany: Federal Ministry of Education and Research

Keywords provided by Johann Wolfgang Goethe University Hospitals:

end-stage renal disease
chronic kidney disease

Additional relevant MeSH terms:

Kidney Diseases
Kidney Failure, Chronic
Urologic Diseases
Renal Insufficiency, Chronic
Renal Insufficiency

ClinicalTrials.gov processed this record on June 17, 2013