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Effect of Broccoli Sprout Extract in Patients With Chronic Kidney Disease With Diabetes Type 2

Not Applicable
Completed
Conditions
Chronic Kidney Disease stage4
Diabetes Mellitus, Type 2
Chronic Kidney Disease Stage 3B
Interventions
Other: Sulforaphane, administered as Broccoli sprout extract
Registration Number
NCT04858854
Lead Sponsor
Karolinska Institutet
Brief Summary

This research project aims to test if sulforaphane, administered as broccoli sprout extract (BSE) can ameliorate glucose control in adult patients with chronic kidney disease (CKD) and DM 2 with GFR \> 15 \< 45 ml/min/1.73 m2. The glucose control will be evaluated by the oral glucose tolerance test. Moreover, as a secondary aim, we will investigate the role of sulforaphane in improving other signs of metabolic derangements present in this group of patients, including oxidate stress, proteinuria, inflammation and a decrease in the production of uremic toxins from the gut microbiota. This a multicentre randomized double-blinded controlled trial including 100 adult patients with CKD and glomerular filtration rate (GFR) between 15 and 29 ml/min/1.73m2, DM type 2, age \> 18 years old. Patients will be randomized into BSE group or Placebo group. Both groups will be followed for 20 weeks: The first 12 weeks patients will receive the BSE or Placebo and, the next 8 weeks, both groups will be followed with no intervention to observe the changes in the primary and secondary outcomes. Patients randomized to BSE Group will receive 50 µmmol/day of sulforaphane administered as BSE (Lantmännen®) from week 0 to week 4. If no side-effects are reported, the sulforaphane dose will increase to 100 µmmol/day from week 5 to week 8 and in the absence of side-effects, the dose will increase to 150 µmmol/day from week 9 to week 12. Blood and urine samples and OGTT (in non-insulin dependent patients) will be performed at week 0, 12 and 20. On week 4 and 8 blood drawn for partial exam will be performed. The BSE and the placebo (maltodextrin sprayed with copper-chlorophyllin) will be administered as powder provided in a double-blind manner as dry mixtures in sealed portion size bags of similar shape and size. Randomization will be done using a computer-based block randomization algorithm. Comparisons between the primary and secondary studied variables will be done with two-way analysis of variance (ANOVA) with repeated measures for normally distributed variables. Variables that can interfere with the glycemic control, such as changes in the dosage of hypoglicemiants agents and insulin during the intervention will be controlled in the analysis. Those non-normally distributed will be log transformed aiming to normalize the distribution. All test will consider a P\<0.05 for statistical significance. The software Stata will be used for the statistical analysis.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Patients with a GFR 15-45 ml/min/1.73 m2, DM type 2, age >18 years old, able to read and understand Swedish.
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Exclusion Criteria
  • Use of metformin, use of warfarin, levels of ASAT, ALAT more than three times the upper limit at screening or at any subsequent visit, kidney transplantation, inflammatory bowel disease, celiac disease, malignant diseases (except skin basalioma) in the previous 3 years, and any other condition that the treating doctor believes is contraindicated; allergy to broccoli; participation in another clinical trial which may affect the outcome of the present study; not to understand the study information.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupSulforaphane, administered as Broccoli sprout extractThe Control Group will receive a placebo (maltodextrin sprayed with copper-chlorophyllin) for 12 weeks.
BSE group (Broccoli sprout group)Sulforaphane, administered as Broccoli sprout extractThe BSE Group will receive 50 µmmol/day of sulforaphane administered by BSE (Lantmännen®) from week 0 to week 4. If no side-effects are reported, the sulforaphane dose will increase to 100 µmmol/day from week 5 to week 8 and in the absence of side-effects, the dose will increase to 150 µmmol/day from week 9 to week 12.
Primary Outcome Measures
NameTimeMethod
Fasting serum glucoseBaseline, Week 12

Change in fasting serum glucose from baseline at week 12

Secondary Outcome Measures
NameTimeMethod
Trimethylamine N-oxide (TMAO)Baseline, Week 12 and Week 20

Uremic toxins

Fasting HbA1cBaseline, Week 12, Week 20 and week 20

Fasting HbA1c

Tumor necrosis alpha (TNF)Baseline, Week 12 and Week 20

Inflammatory marker

8-hydroxydeoxyguanosine (8-OHdG)Baseline, Week 12 and Week 20

Oxidative stress

Fasting insulinBaseline, Week 4, Week 8, Week 12 and Week 20

Fasting insulin

Urinary albumin creatinine ratio (ACR)Baseline, Week 12 and Week 20

Proteinuria

P-cresyl sulfate (IPC)Baseline, Week 12 and Week 20

Uremic toxins

Interleukin-6 (IL6)Baseline, Week 12 and Week 20

Inflammatory marker

C-reactive protein (CRP)Baseline, Week 12 and Week 20

Inflammatory marker

Interleukin 10Baseline, Week 12 and Week 20

Inflammatory marker

Oral glucose tolerance testBaseline, Week 12 and Week 20

Performed in patients not using insulin at the local participating Hospital Chemical

Advanced oxidation protein products (AOPP)Baseline, Week 12 and Week 20

Oxidative stress

Indoxyl-sulfate (IS)Baseline, Week 12 and Week 20

Uremic toxins

Trial Locations

Locations (12)

Sahlgrenska Universitetssjukhuset

🇸🇪

Göteborg, Sweden

Gävle Hospital

🇸🇪

Gävle, Sweden

Skånes University Hospital Sus

🇸🇪

Lund, Sweden

Skånes universitetssjukhus

🇸🇪

Malmö, Sweden

Danderyds sjukhus AB

🇸🇪

Stockholm, Sweden

Norrlands Universitetssjukhus

🇸🇪

Umeå, Sweden

Akademiska sjukhuset

🇸🇪

Uppsala, Sweden

Västervikssjukhus

🇸🇪

Västervik, Sweden

Västmanlands Hospital Västerås

🇸🇪

Västerås, Sweden

Hallands Hospital Varberg

🇸🇪

Varberg, Sweden

Karolinska Institutet

🇸🇪

Stockholm, Sweden

Linköpings universitet

🇸🇪

Linköping, Sweden

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