AzTrials
AzTrials

Type 2 Diabetic NephropathyPhase 4NCT01300273

Low Protein Diet Supplemented With Ketoanalogs on Reducing Proteinuria and Maintaining Nutritional Status in Type 2 Diabetic Nephropathy

A Phase 4 study testing Compound α-Ketoacid Tablet in people with Type 2 Diabetic Nephropathy, run by Shanghai Jiao Tong University School of Medicine at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

The investigators hypothesize that, LPD supplemented with ketoanalogs will reduce urine podocyte loss and lower the angiotensinogen level in the urine. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Type 2 Diabetic Nephropathy
What is being tested?
Compound α-Ketoacid Tablet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteChina
Study dates
Feb 2011to Jul 2012
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • diagnosed with type 2 diabetes
  • age range is 18 - 80 years old
  • no gender restrictions
  • use oral hypoglycemic agents (limited to repaglinide, α-glucosidase inhibitor and chloroquine ketone) and/or insulin to control blood sugar
  • fasting blood sugar is not higher than 10mmol/l, glycated hemoglobin is not higher than 8.5%
  • using RAS system blockers (ACEI or ARB) for at least 4 weeks and blood pressure is no higher than 160/90mmHg. Once enrolled in the group, the dose should not be changed, unless there is contraindication
Show all 9Show fewer
  • has not yet started dialysis, GFR based on simplified MDRD formula is between (15-60) ml/min/1.73m2
  • serum albumin is not less than 25g/l and appearing dominant proteinuria (urinary albumin excretion rate > 300mg/24h)
  • understanding and willing to participate in the trial and signed informed consent

Who cannot join

  • compliance is poor
  • GFR < 15ml/min/1.73m2
  • repeated hypercalcemia, hyperkalemia
  • ketoacidosis occurred in recent 6 months
  • chronic heart failure, above NYHA 3 grade
  • combined with other serious diseases in 3 months
Show all 14Show fewer
  • obvious symptoms and signs of liver disease. Alanine or aspartate aminotransferase 2 times higher than normal
  • severe edema, or up to the level of nephrotic syndrome or that there is serous cavity effusion
  • urinary tract infections or other urinary tract diseases
  • drug abusers
  • diagnosed of malignancy
  • receiving long-term systemic steroid therapy
  • women pregnancy or Intended pregnancy and breastfeeding
  • took part in other clinical drug studies 30 days before the trial

Trial locations and contacts

1 site in 1 country.

China1 site

  • Department of Nephrology,Shanghai Jiaotong University Affiliated First People's Hospital

    Shanghai, Shanghai Municipality, 200080

Other trials in China

About this study

Official title: Phase 4 Study of Mechanisms of Low Protein Diet Supplemented With Ketoanalogs on Reducing Proteinuria and Maintaining Nutritional Status in Type 2 Diabetic Nephropathy

The investigators hypothesize that, LPD supplemented with ketoanalogs will reduce urine podocyte loss and lower the angiotensinogen level in the urine.

Read the detailed description

Diabetic nephropathy is one of the most important causes of end stage renal disease in the world. Recently In a multicenter, randomized clinical trial performed in China, which aimed to evaluate the efficacy and safety of compound α-keto acid tablet in combination with low protein diet (LPD+KA) in delaying the progress of type 2 diabetic nephropathy(T2DN). In that study it was found that LPD+KA was associated with amelioration of proteinuria, better reduction in the loss of kidney function compared with LPD alone meanwhile nutrition status remained well in both group(Role of Ketoanalogs in diabetic nephropathy-China study, to be submitted for publication). However, in that study the mechanisms underlined these effects were not been elucidated This research proposal is a part of the continuation of that study. Restriction of Protein intake, strictly control blood pressure, particularly using renin-angiotensin system (RAS) blockade have been shown to ameliorate proteinuria and progression of CKD. Podocyte damage has been know to play critical role for proteinuria and renal function loss A recent study showed that the mRNA expression of podocyte markers in urinary sediment is increased in patients with T2DN, and this effect can be inhibited by ACE inhibitor and ARB, which indicates the important role of local renal RAS to involve in the damage. Urinary angiotensinogen level is a good marker of the situation of renal RAS. Consequently the investigators are proposing to study the effect of LPD+KA on podocyte as well as on local RAS in the kidney.

Being tested
Compound α-Ketoacid Tablet
Keywords
Diabetic nephropathy, Podocyte, Low Protein Diet, Ketoanalogs
Medical subject headings
Diabetic Nephropathies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Compound α-Ketoacid TabletDietary supplement

    Also called Ketosteril, Ketoanalogs

    30 patients will be treated with a LPD containing 0.6g protein/kg BW per day and 120-125 kJ/kg BW per day and supplemented with keto-amino acids (Ketosteril®, Fresenius Kabi) at a dosage of 100 mg/kg BW per day.

Study groups in NCT01300273
Study groupRoleWhat they receive
KetosterilExperimentalNot described
Receives: Dietary Supplement: Compound α-Ketoacid Tablet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. monitor podocyte loss by detecting nephrin, podocin, and synaptopodin mRNA in urine particulates with quantitative reverse transcriptase-PCR.

    At baseline and every 3 months, a whole-stream early morning urine specimen will be collected for gene expression study.

    Measured: At baseline and every 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Feb 2011 (estimated)
  2. Study startFeb 2011
  3. Primary completionMay 2012 (estimated)
  4. Study completionJul 2012 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01300273
Sponsor's protocol ID
KETO-011-IP4
Status last verified
Sep 2011
First submitted
18 Feb 2011
Last updated
8 Sep 2011
Results posted
No
Data monitoring committee
No

Publications

  • Kasiske BL, Lakatua JD, Ma JZ, Louis TA. A meta-analysis of the effects of dietary protein restriction on the rate of decline in renal function. Am J Kidney Dis. 1998 Jun;31(6):954-61. doi: 10.1053/ajkd.1998.v31.pm9631839.

    PubMed 9631839

  • Mahmood J, Khan F, Okada S, Kumagai N, Morioka T, Oite T. Local delivery of angiotensin receptor blocker into the kidney ameliorates progression of experimental glomerulonephritis. Kidney Int. 2006 Nov;70(9):1591-8. doi: 10.1038/sj.ki.5001872. Epub 2006 Sep 20.

    PubMed 16985512

  • Wang G, Lai FM, Lai KB, Chow KM, Li KT, Szeto CC. Messenger RNA expression of podocyte-associated molecules in the urinary sediment of patients with diabetic nephropathy. Nephron Clin Pract. 2007;106(4):c169-79. doi: 10.1159/000104428. Epub 2007 Jun 26.

    PubMed 17596726

  • Wang G, Lai FM, Lai KB, Chow KM, Kwan BC, Li PK, Szeto CC. Urinary messenger RNA expression of podocyte-associated molecules in patients with diabetic nephropathy treated by angiotensin-converting enzyme inhibitor and angiotensin receptor blocker. Eur J Endocrinol. 2008 Mar;158(3):317-22. doi: 10.1530/EJE-07-0708.

    PubMed 18299464

  • Yamamoto T, Nakagawa T, Suzuki H, Ohashi N, Fukasawa H, Fujigaki Y, Kato A, Nakamura Y, Suzuki F, Hishida A. Urinary angiotensinogen as a marker of intrarenal angiotensin II activity associated with deterioration of renal function in patients with chronic kidney disease. J Am Soc Nephrol. 2007 May;18(5):1558-65. doi: 10.1681/ASN.2006060554. Epub 2007 Apr 4.

    PubMed 17409316

  • Adey D, Kumar R, McCarthy JT, Nair KS. Reduced synthesis of muscle proteins in chronic renal failure. Am J Physiol Endocrinol Metab. 2000 Feb;278(2):E219-25. doi: 10.1152/ajpendo.2000.278.2.E219.

    PubMed 10662705

  • Sato N, Komatsu K, Kurumatani H. Late onset of diabetic nephropathy in spontaneously diabetic GK rats. Am J Nephrol. 2003 Sep-Oct;23(5):334-42. doi: 10.1159/000072915. Epub 2003 Aug 13.

    PubMed 12920324

  • Verity MA. Infantile Pompe's disease, lipid storage, and partial carnitine deficiency. Muscle Nerve. 1991 May;14(5):435-40. doi: 10.1002/mus.880140509.

    PubMed 1870635

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Compound α-Ketoacid Tablet in people with Type 2 Diabetic Nephropathy, run by Shanghai Jiao Tong University School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 8 Sep 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

monitor podocyte loss by detecting nephrin, podocin, and synaptopodin mRNA in urine particulates with quantitative reverse transcriptase-PCR. (time frame: At baseline and every 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01300273, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Sep 2011.

AzTrials uses cookies for analytics and advertising. You can accept or reject them; the site works either way. Privacy Policy.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in