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Study of vitamin D therapy to improve heart function and immune response in patients with chronic kidney disease (CKD)

Not Applicable
Completed
Conditions
eft ventricular hypertrophy (LVH) in patients with non-dialysis dependent chronic kidney disease (CKD stage 3b and 4)
Circulatory System
Registration Number
ISRCTN47936804
Lead Sponsor
Guy's and St. Thomas' NHS Foundation Trust (UK)
Brief Summary

2019 results in https://doi.org/10.1093/ehjcvp/pvz080 (added 13/12/2019)

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
48
Inclusion Criteria

1. Patients aged 18 - 75 years with CKD stage 3b-4
2. Documented 25 hydroxy vitamin D defeciency/insufficiency with serum 25 (OH)D levels between 12.5 to 75 nmol/L
3. Left ventricular mass index (LVMI) between 80 - 160 g/m2 for females and 100 - 160 g/m2 for males
4. Patients on angiotensin converting enzyme inhibitors and/or angiotensin II receptor blockers

Exclusion Criteria

1. Presence of diabetes mellitus (type I and II)
2. Serum calcium greater than 2.55 mmol/L
3. Anaemia (Hb less than 10.0 g/dL or taking regular erythropoiesis stimulating agents)
4. Known malignancy
5. History of congestive cardiac failure or ejection fraction less than 40% on ECHO and/or plasma NT-proBNP greater than 500 pg/ml
6. Uncontrolled hypertension (blood pressure [BP] greater than 150/90 mmHg despite anti-hypertensive medication)
7. Significant valvular heart disease identified on transthoracic ECHO
8 Conditions that may influence collagen metabolism such as recent (less than 6 months) surgery or trauma, fibrotic diseases or active inflammatory conditions
9. Immunosuppressive medications
10. Presence of arterio-venous fistula for dialysis access
11. History of previous myocardial infarction (Trop T greater than 0.5)

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
<br> 1. 10g improvement in left ventricular mass (LVM) with oral vitamin D therapy over 1 year<br> 2. Difference in LVM in patients treated with vitamin D compared to controls<br><br> Measured at 52 weeks from enrolment.<br>
Secondary Outcome Measures
NameTimeMethod
<br> 1. Reduction in cardiac fibrosis determined by biomarkers of cardiac fibrosis in serum post vitamin D3 therapy<br> 2. Augmentation of adaptive immune response to Hepatitis B vaccination post oral vitamin D3 supplementation<br> 3. Immune regulation with predominantly antiinflammatory response with oral vitamin D3 therapy<br> 4. Measured at 52 weeks from enrolment.<br>
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