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Autosomal Dominant Polycystic Kidney DiseasePhase 2RAFALENCT01932450

Radiofrequency Ablation for ADPKD Blood Pressure and Disease Progression Control

A Phase 2 study testing renal sympathetic denervation and antihypertensive drugs in people with Autosomal Dominant Polycystic Kidney Disease and Hypertension, run by Mei changlin 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 The sponsor has not verified this record for over two years, so it may be out of date.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
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Trial summary

A randomized, open-label single-center study investigates the efficacy and safety of bilateral renal artery sympathetic denervation by catheter-based radiofrequency ablation on blood pressure and disease progression control in autosomal dominant polycystic kidney disease(ADPKD). Read more about this study

Who is it for?
Ages 20 to 60 years
What is being tested?
renal sympathetic denervation and antihypertensive drugs
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
1 siteChina
Study dates
Aug 2013to Jul 2015
Phase
Phase 2
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 20 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Patients with ADPKD.
  • Having hypertension, defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, and currently using 2 antihypertensive drugs and receiving a stable antihypertensive treatment regimen without change in dose or medication in the previous 30 days.
  • Male and female patients 20 years to 60 years of age.
  • Glomerular Filtration Rate (GFR) ≥30 ml/min/1.73 m2, estimated from serum creatinine using the Chronic Kidney Disease Epidemiology collaboration(CKD-EPI) equation.
  • Have followed-up kidney and cyst volume at least 6 months in Shanghai Changzheng Hospital.
  • Signed Informed Consent after being informed.

Who cannot join

  • Documented renal vascular disease.
  • Congenital absence of a kidney.
  • Systemic illness with renal involvement.
  • Spot urine albumin-to-creatinine ratio of >0.5 g/g and/or findings suggestive of kidney disease other than ADPKD.
  • Exclusions specific to MRI acquisition and measurement: cardiac pacemaker, presence of MRI incompatible metallic clips or other material, excessive body weight, untreatable claustrophobia.
  • Contraindications to the catheter-based renal denervation procedure by RFA, including allergy to radioiodinated contrast agents. Anatomical abnormalities of the renal arteries which preclude RFA: presence in either kidneys of multiple main renal arteries, main renal artery stenosis >50%, or main renal arteries of <4 mm in diameter or <20 mm in length.
Show all 16Show fewer
  • Contraindications on ethical grounds.
  • Women who are pregnant or breast feeding.
  • Intention to become pregnant during the course of the study.
  • Lack of safe contraception: Female subjects of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases (Female subjects who are surgically sterilized/hysterectomized or post-menopausal for longer than 2 years are not considered as being of child bearing potential).
  • Other clinically significant concomitant disease states (hepatic dysfunction, cardiovascular disease, metastatic cancer).
  • Known or suspected non-compliance, drug or alcohol abuse.
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia or confusional state of the subject.
  • Participation in another study with investigational drug within the 30 days preceding and during the present study.
  • Previous enrolment into the current study.
  • Enrolment of the investigator, his/her family members, employees and other dependent persons.

Trial locations and contacts

1 site in 1 country.

Changlin Mei, MD contact

+86 21 81885391

chlmei1954@126.com

Yiyi Ma, Master contact

+8613661679863

dukemm@126.com

China1 site, 1 recruiting
  • Department of Nephrology, Shanghai Changzheng Hospital

    Shanghai, Shanghai Municipality, 200003

    Changlin Mei, MD, +862181885391, chlmei1954@126.com

    Yiyi Ma, Master, +8613661679863, dukemm@126.com

    Recruiting

Other trials in China

About this study

Official title: A Randomized, Open-label Study Investigating the Effect of Bilateral Renal Artery Sympathetic Denervation by Catheter-based Radiofrequency Ablation on Blood Pressure and Disease Progression in Autosomal Dominant Polycystic Kidney Disease

A randomized, open-label single-center study investigates the efficacy and safety of bilateral renal artery sympathetic denervation by catheter-based radiofrequency ablation on blood pressure and disease progression control in autosomal dominant polycystic kidney disease(ADPKD). The total number of study subjects will be 100. All of them have diagnosed with ADPKD and hypertension. Patients will be randomized 1:1 (50 with radiofrequency ablation(RFA), 50 only with drugs). Change in average office-based measurements of systolic blood pressure(SBP), average 24-hour systolic blood pressure by ambulatory blood pressure monitoring (ABPM) , incidence of office systolic blood pressure reductions of ≥10, ≥15 and ≥20 mm Hg , office diastolic blood pressure (DBP), number and dosage of blood pressure tablets, total kidney volume (TKV), total cyst volume (TCV), pain related to cystic kidneys and renal function, will be assessed at 12 months of follow-up. The safety variables will be assessed at every visit of follow-up.

Being tested
renal sympathetic denervation, antihypertensive drugs
Keywords
hypertension, radiofrequency ablation, autosomal dominant polycystic kidney disease
Medical subject headings
Polycystic Kidney, Autosomal Dominant, Hypertension

What participants receive

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

  • renal sympathetic denervationProcedure or surgery

    Also called Percutaneous radiofrequency ablation of renal nerves, Transcatheter renal denervation, renal denervation, renal ablation

    One-time standard Catheter-based renal sympathetic denervation will be performed in both renal arteries by radiofrequency ablation.

  • antihypertensive drugsDrug

    antihypertensive drugs have been used from baseline in patients, and will be modified by patient's blood pressure.

Study groups in NCT01932450
Study groupRoleWhat they receive
renal sympathetic denervationExperimentalOne-time standard bilateral renal sympathetic denervation by catheter-based radiofrequency ablation and using antihypertensive drugs which at least include an angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB).
Receives: Procedure: renal sympathetic denervation; Drug: antihypertensive drugs
antihypertensive drugsActive comparatorBlood pressure control in ADPKD patients with hypertension only using antihypertensive drugs which at least include an angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB)
Receives: Drug: antihypertensive drugs

What is being measured

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

  1. office-based measurements of systolic blood pressure

    Between-group change in average office-based measurements of systolic blood pressure from baseline to 12 months after randomization and One-time standard bilateral renal sympathetic denervation by catheter-based radiofrequency ablation.

    Measured: baseline and 12 months (day 360±14)

Secondary outcomes (16)
  1. 24-hour systolic blood pressure by ambulatory blood pressure monitoring (ABPM)

    Change in average 24-hour systolic blood pressure by ambulatory blood pressure monitoring (ABPM) from baseline to 12 month.

    Measured: baseline and 12 months (day 360±14)

  2. Incidence of office systolic blood pressure reduction

    Incidence of office systolic blood pressure reductions of ≥10, ≥15 and ≥20 mm Hg from baseline to 12 month.

    Measured: baseline and 12 months (day 360±14)

  3. office diastolic blood pressure

    Change in office diastolic blood pressure from baseline to 12 months.

    Measured: baseline and 12 months (day 360±14)

  4. number and dosage of blood pressure tablets

    Change in number and dosage of blood pressure tablets from baseline to 12 months.

    Measured: baseline and 12 months (day 360±14)

  5. estimated Glomerular Filtration Rate(eGFR)

    Change in estimated Glomerular Filtration Rate(eGFR) from baseline to 12 months.

    Measured: baseline and 12 months (day 360±14)

  6. albuminuria

    Change in albuminuria from baseline to 12 months.

    Measured: baseline and 12 months (day 360±14)

  7. total kidney volume (TKV)

    Change in total kidney volume (TKV) from baseline to 12 months

    Measured: baseline and 12 months (day 360±14)

  8. pain

    Change in pain related to cystic kidneys from baseline to 12 months.

    Measured: baseline and 12 months (day 360±14)

  9. procedure-related complications at femoral puncture site

    Occurrence of procedure-related complications at femoral puncture site (hematoma, arteriovenous fistula, pseudoaneurysma).

    Measured: up to 1 year (after radiofrequency ablation)

  10. Renal artery lesion

    Renal artery lesion (perforation or dissection).

    Measured: up to 1 year (after radiofrequency ablation)

  11. New renal artery stenosis

    New renal artery stenosis >70%, determined by MRI within 12 months of randomization.

    Measured: up to 1 year (after radiofrequency ablation)

  12. Embolic events

    Embolic events.

    Measured: up to 1 year (after radiofrequency ablation)

  13. hypotension

    Episodes of hypotension.

    Measured: up to 1 year (after radiofrequency ablation)

  14. hypertension.

    Episodes of hypertension.

    Measured: up to 1 year (after radiofrequency ablation)

  15. acute kidney injury

    Acute deterioration of renal function

    Measured: up to 1 year (after radiofrequency ablation)

  16. total cyst volume (TCV)

    Change in total cyst volume (TCV) from baseline to 12 months

    Measured: baseline and 12 months (day 360±14)

Timeline

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

  1. First posted30 Aug 2013 (estimated)
  2. Study startAug 2013
  3. Primary completionDec 2014 (estimated)
  4. Study completionJul 2015 (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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01932450
Sponsor's protocol ID
CZKIPLA-ADPKD-001
Acronym
RAFALE
Status last verified
Sep 2014
First submitted
18 Aug 2013
Last updated
25 Sep 2014
Results posted
No
Data monitoring committee
Yes

Publications

  • Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet. 2007 Apr 14;369(9569):1287-1301. doi: 10.1016/S0140-6736(07)60601-1.

    PubMed 17434405
  • Harris PC, Torres VE. Polycystic kidney disease. Annu Rev Med. 2009;60:321-37. doi: 10.1146/annurev.med.60.101707.125712.

    PubMed 18947299
  • Grantham JJ. Clinical practice. Autosomal dominant polycystic kidney disease. N Engl J Med. 2008 Oct 2;359(14):1477-85. doi: 10.1056/NEJMcp0804458. No abstract available.

    PubMed 18832246
  • Chang MY, Ong AC. Autosomal dominant polycystic kidney disease: recent advances in pathogenesis and treatment. Nephron Physiol. 2008;108(1):p1-7. doi: 10.1159/000112495. Epub 2007 Dec 13.

    PubMed 18075279
  • Neumann J, Ligtenberg G, Klein IH, Blankestijn PJ. Pathogenesis and treatment of hypertension in polycystic kidney disease. Curr Opin Nephrol Hypertens. 2002 Sep;11(5):517-21. doi: 10.1097/00041552-200209000-00007.

    PubMed 12187316
  • Chapman AB, Johnson AM, Rainguet S, Hossack K, Gabow P, Schrier RW. Left ventricular hypertrophy in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 1997 Aug;8(8):1292-7. doi: 10.1681/ASN.V881292.

    PubMed 9259356
  • Ecder T, Schrier RW. Hypertension in autosomal-dominant polycystic kidney disease: early occurrence and unique aspects. J Am Soc Nephrol. 2001 Jan;12(1):194-200. doi: 10.1681/ASN.V121194. No abstract available.

    PubMed 11134267
  • Chapman AB, Stepniakowski K, Rahbari-Oskoui F. Hypertension in autosomal dominant polycystic kidney disease. Adv Chronic Kidney Dis. 2010 Mar;17(2):153-63. doi: 10.1053/j.ackd.2010.01.001.

    PubMed 20219618
  • Cerasola G, Vecchi M, Mule G, Cottone S, Mangano MT, Andronico G, Contorno A, Parrino I, Renda F, Pavone G. Sympathetic activity and blood pressure pattern in autosomal dominant polycystic kidney disease hypertensives. Am J Nephrol. 1998;18(5):391-8. doi: 10.1159/000013382.

    PubMed 9730562
  • Klein IHHT, Ligtenberg G, Oey PL, Koomans HA, Blankestijn PJ. Sympathetic activity is increased in polycystic kidney disease and is associated with hypertension. J Am Soc Nephrol. 2001 Nov;12(11):2427-2433. doi: 10.1681/ASN.V12112427.

    PubMed 11675419
  • Schrier RW. Hypertension and autosomal dominant polycystic kidney disease. Am J Kidney Dis. 2011 Jun;57(6):811-3. doi: 10.1053/j.ajkd.2011.02.379. No abstract available.

    PubMed 21601126
  • Chapman AB, Torres VE, Perrone RD, Steinman TI, Bae KT, Miller JP, Miskulin DC, Rahbari Oskoui F, Masoumi A, Hogan MC, Winklhofer FT, Braun W, Thompson PA, Meyers CM, Kelleher C, Schrier RW. The HALT polycystic kidney disease trials: design and implementation. Clin J Am Soc Nephrol. 2010 Jan;5(1):102-9. doi: 10.2215/CJN.04310709.

    PubMed 20089507
  • Torres VE, Chapman AB, Perrone RD, Bae KT, Abebe KZ, Bost JE, Miskulin DC, Steinman TI, Braun WE, Winklhofer FT, Hogan MC, Oskoui FR, Kelleher C, Masoumi A, Glockner J, Halin NJ, Martin DR, Remer E, Patel N, Pedrosa I, Wetzel LH, Thompson PA, Miller JP, Meyers CM, Schrier RW; HALT PKD Study Group. Analysis of baseline parameters in the HALT polycystic kidney disease trials. Kidney Int. 2012 Mar;81(6):577-85. doi: 10.1038/ki.2011.411. Epub 2011 Dec 28.

    PubMed 22205355
  • Gattone VH 2nd, Siqueira TM Jr, Powell CR, Trambaugh CM, Lingeman JE, Shalhav AL. Contribution of renal innervation to hypertension in rat autosomal dominant polycystic kidney disease. Exp Biol Med (Maywood). 2008 Aug;233(8):952-7. doi: 10.3181/0802-RM-54. Epub 2008 May 14.

    PubMed 18480417
  • Chapuis O, Sockeel P, Pallas G, Pons F, Jancovici R. Thoracoscopic renal denervation for intractable autosomal dominant polycystic kidney disease-related pain. Am J Kidney Dis. 2004 Jan;43(1):161-3. doi: 10.1053/j.ajkd.2003.07.026.

    PubMed 14712440

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing renal sympathetic denervation and antihypertensive drugs in people with Autosomal Dominant Polycystic Kidney Disease and Hypertension, run by Mei changlin 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 6 inclusion and 16 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 25 Sep 2014. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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?

Contact Changlin Mei, MD (+86 21 81885391, chlmei1954@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

office-based measurements of systolic blood pressure (time frame: baseline and 12 months (day 360±14)). 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 NCT01932450, which also lists 39 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 25 Sep 2014.

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