Trace Element Replenishment Study in Hemodialysis Patients
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 150
- 试验地点
- 4
- 主要终点
- Proportion of participants with zinc deficiency
研究概览
简要总结
A pilot randomized trial that compares a new renal nutritional supplement with the standard renal vitamin.
The primary objective is to compare two doses (medium and high) of the new supplement with the renal vitamin currently being prescribed to people with End Stage Renal Disease (ESRD).
Secondary objective is to demonstrate the feasibility of recruitment for a definitive larger trial.
详细描述
People with severe kidney disease follow a restricted diet aimed at reducing intake of sodium, potassium and phosphate. These dietary restrictions require reducing their intake of many fresh fruits and vegetables, which may lead to nutritional deficiency. Although the potential for malnutrition in people with kidney disease is well recognized, blood levels of most vitamins and trace elements are rarely measured. Instead, most North Americans with severe kidney disease are routinely prescribed a "renal vitamin" such as Replavite which contains a mixture of B and C vitamins.
Recent evidence (including our work; see http://www.biomedcentral.com/bmcmed/subjects/nephrology) indicates that people with severe kidney disease are often deficient in several other biologically essential substances (selenium, zinc) that are readily amenable to supplementation. Pilot data from the Northern Alberta Renal Program (NARP) indicate that approximately 90% of patients have zinc levels below the lower limit of normal; findings for selenium are similar.
Potential benefits of zinc supplementation include improvements in immune function, taste sensitivity (perhaps reducing dietary sodium intake), and improved appetite. Potential benefits of selenium supplementation include reductions in the risk of vascular disease and infection. Supplementation with vitamin E was shown in a randomized trial to reduce serious cardiovascular morbidity in people with kidney failure, but is not routinely used in dialysis patients. This suggests that supplementation of zinc, selenium, and vitamin E has theoretical benefits in kidney failure. Since patients with kidney failure already take many medications, it is logical to combine any new nutritional supplements with the ingredients of the standard renal vitamin to reduce pill burden.
This protocol concerns a novel nutritional supplement consisting of zinc, selenium and vitamin E in addition to the contents of the standard renal supplement of B and C vitamins.
This pilot randomized, double blind trial will compare 2 doses of the new supplement with the standard renal vitamin.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Stable on hemodialysis for 3 to 36 months
- •Age greater or equal to 18 years
- •Receiving Replavite or equivalent renal vitamin at baseline
- •Receiving 3 dialysis treatments per week
排除标准
- •Pregnant (sexually active pre-menopausal females must have negative serum pregnancy test at baseline)
- •Pregnancy, kidney transplantation, a dialysis modality switch, or gastrointestinal surgery planned within 6 months
- •Known allergy to corn starch
- •Known allergy to zinc, selenium, vitamin E or renal vitamin.
- •Projected life expectancy of <6 months
- •Any other conditions or procedures that, in the opinion of the investigator, would impede absorption of the study product.
- •Participants already taking a vitamin E, zinc or selenium supplement (alone or included in another multi-vitamin).
- •Individuals with a history of head or neck cancer in the past 5 years.
- •Ostomy or short gut syndrome.
- •Enroll in another (interventional) trial.
结局指标
主要结局
Proportion of participants with zinc deficiency
时间窗: 90 days following baseline
Proportion of participants with zinc deficiency in the combined experimental arms compared to the proportion of participants with zinc deficiency in the active comparator arm.
次要结局
- Proportion of participants with zinc deficiency(180 days following baseline)
- Proportion of participants with selenium deficiency(90 days and 180 days following baseline)
- Zinc(90 days and 180 days following baseline)
- Selenium(90 days and 180 days following baseline)
研究者
Marcello Tonelli
MD, Professor
University of Alberta