Targeting Peroxisome Proliferator-activated Receptor-gamma in Peritoneal Dialysis Patients - Will it Reduce Inflammation, Atherosclerosis, Calcification and Improve Survival of Peritoneal Dialysis Patients?
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 160
- 试验地点
- 2
- 主要终点
- carotid athersclerosis
研究概览
简要总结
Peritoneal dialysis patients are at increased risk of cardiovascular morbidity and mortality and are related to the presence of accelerated atherosclerosis. Our recent data showed that inflammation predicts mortality and cardiovascular death, independent of other cardiovascular risk factors in peritoneal dialysis patients. As a considerable proportion of peritoneal dialysis patients showed evidence of inflammation, it raises an important question as to whether anti-inflammatory treatment has any cardiovascular and survival benefit in these patients. The peroxisome proliferator-activated receptor-gamma (PPAR-g) agonist is a class of drug with insulin sensitizing property. Recent experimental and clinical studies demonstrated that this class of drug has anti-inflammatory and anti-atherosclerotic properties other than insulin sensitizing effect in type 2 diabetics. We therefore hypothesize that modulation of the PPAR-g activity may be a novel therapeutic strategy for reducing inflammation and retarding the progression of atherosclerosis and possibly lowering mortality in our peritoneal dialysis patients.
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
- Double
入排标准
- 年龄范围
- 20 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Both prevalent patients or patients newly started on continuous ambulatory peritoneal dialysis with age between 20 - 75 with or without diabetes mellitus will be considered eligible for study entry. For patients newly started on continuous ambulatory peritoneal dialysis, they will be suitable for recruitment into the study after one month on continuous ambulatory peritoneal dialysis.
排除标准
- •Patients with underlying malignancy
- •Patients with chronic liver disease or liver cirrhosis
- •Patients with hepatitis B or C positive
- •Patients with active infections
- •Patients with other chronic active inflammatory disease such as systemic lupus erythematosus, rheumatoid arthritis
- •Patients who refuse study participation
- •Patients with underlying congenital heart disease or rheumatic heart disease
- •Patients with poor general condition
- •Patients with plans for living related kidney transplant within 2 years
- •Female patients with pregnancy
- •Patients with history of recurrent hypoglycemia
- •Patients with Class III and IV congestive heart failure
- •Patients already receiving glitazones treatment at the screening visit
结局指标
主要结局
carotid athersclerosis
时间窗: 6 month, 1 year and 2 year
endothelial function
时间窗: 6 month, 1 year and 2 year
次要结局
- all-cause mortality and cardiovascular event(1 year, 2 year)
- pulse wave velocity(6 month, 1 year, 2 year)
- inflammation(6 month, 1 year, 2 year)