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Arterial Stiffness and Calcifications in Haemodialysis Patients on Sevelamer or Calcium Acetate

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00364000
Recruitment Status : Withdrawn (Limitted financial resources)
First Posted : August 15, 2006
Last Update Posted : December 22, 2017
Information provided by (Responsible Party):
Liliana Garneata, Romanian Society of Nephrology

Brief Summary:

End-stage renal disease (ESRD) is a state of increased arterial stiffness of extensive vessel calcifications, compared with the non-renal population. Both arterial stiffness and arterial calcifications are potent predictors of all-cause and cardiovascular mortality in ESRD patients. Several studies have documented the direct relationship between the extent and severity of arterial/coronary calcifications and outcome in dialysis patients. The relationship is strong no matter if arterial calcifications were quantified by electron-beam computed tomography or a radiological calcification score. Calcifications are early and progressive events in these patients. PWV is strongly related to the degree of sonographic determined arterial calcifications and EBCT-derived coronary artery calcium score in chronic kidney disease patients.

Calcium-based phosphate binders are associated with progressive coronary artery and aortic calcification, especially when mineral metabolism is not well controlled.

According to recent studies, sevelamer hydrochloride is a potent non-calcium-containing phosphate binder, well tolerated in ESRD. Compared with calcium-based phosphate binders, sevelamer is less likely to cause hypercalcemia, low levels of PTH, and progressive coronary and aortic calcification in hemodialysis patients. Moreover, sevelamer has a favorable effect on the lipid profile.

Less is known about the relationship between sevelamer treatment and progression of arterial stiffness. To date, there is one single study examining the influence of sevelamer (versus calcium carbonate) on the evolution of arterial stiffness in a very small number (N=15) of haemodialysis patients. These study used the same patients as historical controls, thus being methodologically rather weak. Moreover, the follow-up was quite short - 6 month.

The aim of the trial is to to quantify, in a randomized opened-labeled controlled trial the effect of sevelamer hydrochloride on the evolution of arterial stiffness parameters (pulse wave velocity and the augmentation index) in chronic haemodialysis patients and to correlate these parameters with arterial calcification assessed by a previous described radiological score of arterial calcification and echocardiographic parameters (left ventricular hypertrophy, LV dilatation, systolic and diastolic dysfunction).

Condition or disease Intervention/treatment
Haemodialyzed Patients Hyperphosphatemia Drug: Calcium acetate Drug: Sevelamer

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Arterial Stiffness and Arterial Calcifications Evolution in ESRD Haemodialysis Patients Treated by Sevelamer or Calcium Acetate
Actual Study Start Date : January 2012
Primary Completion Date : July 2015
Study Completion Date : December 2017

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Active Comparator: I
Calcium acetate 670 mg tablets
Drug: Calcium acetate
Calcium acetate in 240 chronic HD patients
Experimental: II
label sevelamer (RenagelR) 800 mg tablets
Drug: Calcium acetate
Calcium acetate in 240 chronic HD patients
Drug: Sevelamer
label sevelamer (RenagelR) 800 mg tablets

Primary Outcome Measures :
  1. changes in arterial stiffness parameters [ Time Frame: 6 months ]
  2. changes in calcification score [ Time Frame: 6 months ]

Secondary Outcome Measures :
  1. composite of all-cause mortality, cardiovascular mortality and major cardiovascular events [ Time Frame: 1 year ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • more than 3 months on haemodialysis
  • willingness to participate
  • age 18-60 yrs
  • pre-dialysis blood pressure 120-160 mmHg in the last month prior to the initiation of study or recent (<1 Mo) addition of a new antihypertensive drug
  • iPTH at entry 200-800 pg/mL (as per severe hyperparathyroidism)
  • serum calcium at entry 2.2-2.6 mmol/L

Exclusion Criteria:

  • haemodynamic instability
  • uncontrolled hypertension
  • any severe, debilitating disease associated with a reduced survival
  • any major cardiovascular event in the last 12 month before study
  • cinacalcet therapy before study entrance
  • history of parathyroidectomy
  • documented history of poor compliance
  • serious gastrointestinal disease

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00364000

"Dr Carol Davila" Teaching Hospital of Nephrology
Bucharest, Romania, 010731
"CI Parhon" Clinical Hospital
Iasi, Romania
Sponsors and Collaborators
Romanian Society of Nephrology
Study Director: Adrian Covic, Prof "CI Parhon" Clinical Hospital, Iasi
Study Director: Gabriel Mircescu, Prof "Dr Carol Davila" Teaching Hospital of Nephrology, Bucharest, Romania

Responsible Party: Liliana Garneata, MD. PHD, Romanian Society of Nephrology Identifier: NCT00364000     History of Changes
Other Study ID Numbers: 02_2006
First Posted: August 15, 2006    Key Record Dates
Last Update Posted: December 22, 2017
Last Verified: December 2017

Keywords provided by Liliana Garneata, Romanian Society of Nephrology:
calcium acetate

Additional relevant MeSH terms:
Calcium Metabolism Disorders
Metabolic Diseases
Phosphorus Metabolism Disorders
Calcium, Dietary
Calcium acetate
Bone Density Conservation Agents
Physiological Effects of Drugs
Chelating Agents
Sequestering Agents
Molecular Mechanisms of Pharmacological Action