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Pathophysiology of Martorell Hypertensive Ischemic Leg Ulcer (HYTILU)

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ClinicalTrials.gov Identifier: NCT01578382
Recruitment Status : Completed
First Posted : April 16, 2012
Last Update Posted : June 18, 2021
Sponsor:
Information provided by (Responsible Party):
University of Zurich

Study Description
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Brief Summary:

Martorell hypertensive ischemic leg ulcer is a severe type of skin necrosis (skin infarction) which occurs in long-term hypertensive subjects.

Calciphylaxis (calcific uremic arteriolopathy) is a severe type of skin necrosis (skin infarction) which occurs in subjects with end-stage kidney disease or after kidney transplantation.


Condition or disease
Hypertensive Ischemic Leg Ulcer Calciphylaxis

Detailed Description:

Comparative study including

  • 20 consecutive patients with Martorell HYTILU
  • 10 consecutive patients with Calciphylaxis (calcific uremic arteriolopathy)
  • 20 patients with venous ulcer

The following parameters are measured in the blood serum:

White blood count; c-reactive protein; creatinine; calcium (total); free (ionized) calcium; phosphate; albumin; 25-hydroxyvitamin-D; 1-25-dihydroxyvitamin-D; homocysteine; cystatin C alphafetoin, osteoprotegerin; fibroblast growth factor 23 (FGF-23); globular arrest 1 (GLA-1)

The following parameters are measured in samples of diseased (necrobiotic) skin:

alphafetoin, osteoprotegerin; fibroblast growth factor 23 (FGF-23); globular arrest 1 (GLA-1)

Study Design
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Study Type : Observational
Actual Enrollment : 120 participants
Observational Model: Case-Control
Time Perspective: Prospective
Official Title: Pathophysiology of Martorell Hypertensive Ischemic Leg Ulcer (HYTILU): A Comparison of Martorell HYTILU, Calciphylaxis and Venous Ulcer (Control)
Study Start Date : September 2011
Actual Primary Completion Date : December 2019
Actual Study Completion Date : December 2019

Resource links provided by the National Library of Medicine


Groups and Cohorts
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Group/Cohort
Hypertensive ischemic leg ulcer

Twenty consecutive patients with Martorell HYTILU as defined in:

Arch Dermatol 2010;146:961-968
Calciphylaxis

Ten subjects with calciphylaxis (calcific uremic arteriolopathy) as described in:

Vasa 1998;27:137-143
Venous ulcer (controls)

Twenty subjects with venous ulcers (CEAP C4-6) as described in:

J Vasc Surg. 2004 Dec;40(6):1248-52


Outcome Measures
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Primary Outcome Measures :
  1. Martorell HYTILU and calciphylaxis show both decreased tissue protection mechanisms against tissue calcification [ Time Frame: 36 months ]

    Comparison of the calcification-protective factors GLA-1(serum protein alpha2-Heremans-Schmid glycoprotein/fetuin A), Osteoprotegerin, Fibroblast Growth Factor 23, and Alphafetoin in:

    • Martorell HYTILU (A1)
    • Calciphylaxis (calcific uremic arteriolopathy)(A2)
    • Venous ulcers (as control group)(B)


Secondary Outcome Measures :
  1. Martorell hypertensive ischemic leg ulcer and calciphylaxis are both characterized by non-infectious inflammation [ Time Frame: 36 months ]

    Comparison of C-reactive protein, procalcitonin and white blood cell count in:

    • Martorell HYTILU (A1)
    • Calciphylaxis (calcfic uremic arteriolopathy) (A2)
    • Venous ulcers (control group) (B)


Biospecimen Retention:   Samples With DNA
Blood serum (2 tubes); blood plasma in citrate (2 tubes); blood plasma in heparin (2 tubes) Diseased skin tissue in formalin for paraffin embedded H-E histology; Diseased skin tissue snap frozen Diseased skin tissue in "RNA later" tube (1 tube)

Eligibility Criteria
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Ages Eligible for Study:   20 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
n=20: Having Martorell hypertensive ischemic leg ulcer (as defined above) or n=10: Having Calciphylaxis (calcific uremic arteriolopathy (as defined above) or n=20: Having a venous ulcer (as defined above) (controls)
Criteria

Inclusion Criteria:

  • Having Martorell hypertensive ischemic leg ulcer (as defined above) or
  • Having Calciphylaxis (calcific uremic arteriolopathy (as defined above) or
  • Having a venous ulcer (as defined above)

Exclusion Criteria:

  • None
Contacts and Locations
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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 ClinicalTrials.gov identifier (NCT number): NCT01578382


Locations
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Switzerland
Department of Dermatology, University Hospital of Zurich
Zurich, ZH, Switzerland, CH-8091
Sponsors and Collaborators
University of Zurich
Investigators
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Principal Investigator: Jürg Hafner, Professor Department of Dermatology, University Hospital of Zurich, Switzerland
More Information
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Responsible Party: University of Zurich
ClinicalTrials.gov Identifier: NCT01578382    
Other Study ID Numbers: KEK-ZH-NR2010-0433/0
First Posted: April 16, 2012    Key Record Dates
Last Update Posted: June 18, 2021
Last Verified: June 2021
Keywords provided by University of Zurich:
Martorell hypertensive ischemic leg ulcer
Calciphylaxis (calcific uremic arteriolopathy)
Ischemic subcutaneous arteriolosclerosis
Hypertension
 Diabetes
Medial calcinosis
Wound healing
Additional relevant MeSH terms:
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Leg Ulcer
Calciphylaxis
Ischemia
Ulcer
Pathologic Processes
 Skin Ulcer
Skin Diseases
Calcinosis
Calcium Metabolism Disorders
Metabolic Diseases