Nephrotic SyndromePhase 1/2CAPTAINNCT04850378
Causes and Prevention of Thromboembolic Disease in Nephrotic Syndrome
A Phase 1/2 study testing Dalteparin and Apixaban in people with Nephrotic Syndrome and Thromboembolic Disease, run by University of Aarhus at 1 site in Denmark.
Trial summary
The study aims to describe the biochemical coagulation profile and investigate the effect of Low molecular weight heparin and Apixaban on this profile in patients with nephrotic syndrome. Read more about this study
- Who is it for?
- Ages 18 to 79 years
- Conditions the study is for
- Nephrotic Syndrome, Thromboembolic Disease
- What is being tested?
- Dalteparin and Apixaban
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 57 participants
- Where
- 1 siteDenmark
- Study dates
- 25 Mar 2021to 1 May 2024
- Phase
- Phase 1/2
- 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 18 to 79 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18-79 years
- Estimated Glomerular Filtration Rate (eGFR) > 49 mL/min/1.73 m2
- P-albumin < 30 g/L
- U-Albumin excretion > 2.2 g/day
- Known glomerular disease including membranous nephropathy, which may cause nephrotic syndrome or diagnostically unresolved nephrotic syndrome with a planed kidney biopsy.
- Inclusion Criteria: Nephrotic patients treated with Dalteparin
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- Age 18-79 years
- eGFR > 49 mL/min/1.73 m2
- P-albumin < 25 g/L
- U-Albumin excretion > 2.2 g/day
- Known glomerular disease including membranous nephropathy, which may cause nephrotic syndrome or diagnostically unresolved nephrotic syndrome with a planed kidney biopsy.
- Inclusion Criteria: Nephrotic patients treated with Apixaban
- Age 18-79 years
- eGFR > 49 mL/min/1.73 m2
- P-albumin < 25 g/L
- U-Albumin excretion > 2.2 g/day
- Membranous Nephropathy
- Inclusion Criteria: Patients with atrial fibrillation treated with Apixaban
- Age 18-79 years
- eGFR > 49 mL/min/1.73 m2
- P-albumin > 36 g/L
- U-Albumin excretion < 300 mg/day
- Atrial Fibrillation
Who cannot join
- Contraindication to Apixaban
- Contraindication to Dalteparin
- Known allergy or intolerance to Apixaban
- Known allergy or intolerance to Dalteparin
- Treatment with anticoagulation for other reasons.
- Treatment with cyclooxygenase-1-inhibitors or Adenosine Diphosphate (ADP) receptor inhibitors.
Show all 10Show fewer
- Known acquired or congenital coagulation defect non related to nephrotic syndrome or thromboembolic disease within 3 months.
- Known diabetes mellitus.
- Lack of compliance, comorbidity or other conditions that, in the patients unfit to participate in the trial.
- Pregnancy
Trial locations and contacts
1 site in 1 country.
About this study
The study aims to describe the biochemical coagulation profile and investigate the effect of Low molecular weight heparin and Apixaban on this profile in patients with nephrotic syndrome.
Read the detailed description
The initial part of the study is a prospective cross-sectional study which will describe the biochemical coagulation profile in nephrotic patients. It will include 60 patients with nephrotic syndrome and data from 50 anonymous blood donors matched in age and gender for comparison.
The second part of the study is an open-label, controlled, non-randomized, interventional clinical trial consisting of 3 groups of patients with nephrotic syndrome or atrial fibrillation treated with either Dalteparin or Apixaban. The study participant is expected to be in stable condition after 4 full days of treatment. For administrative reasons, the final biochemical tests are performed on day 4, 5, 6 or 7 described as day 4 in this protocol.
- Group A: Up to 50 patients with nephrotic syndrome treated with injection Dalteparin 200 Units/kg subcutaneous once a day for 4 days
- Group B: 10 patients with nephrotic syndrome and membranous nephropathy treated with Apixaban 5 mg twice daily for 4 days.
- Group C: 10 patients with atrial fibrillation and no kidney disease treated with Apixaban 5 mg twice daily for 4 days.
Patients participating in the initial part of the study will be included in det second part (Group A) if they meet the inclusion criteria. If the patient is diagnosed with membranous nephropathy it is possible to be included in the initial part as well as the second part (Group A and B).
- Conditions
- Nephrotic Syndrome, Thromboembolic Disease
- Being tested
- Dalteparin, Apixaban
- Keywords
- Nephrotic Syndrome, Glomerulonephritis, Hypoalbuminemia, Proteinuria, Thromboembolic Disease, Membranous Nephropathy
- Medical subject headings
- Nephrotic Syndrome, Thromboembolism, Glomerulonephritis, Hypoalbuminemia, Proteinuria, Glomerulonephritis, Membranous
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DalteparinDrug
Also called Fragmin
Drug: Dalteparin 200 units/kg once a day for 4-7 days.
ApixabanDrug
Also called Eliquis
Drug: Apixaban 5 mg twice a day for 4-7 days.
| Study group | Role | What they receive |
|---|---|---|
| Coagulation profile in Nephrotic syndrome | No intervention | Investigation of the biochemical coagulation profile in patients with nephrotic syndrome. |
| Nephrotic syndrome | Experimental | Nephrotic patients without diabetes. Receives: Drug: Dalteparin |
| Membranous nephropathy and nephrotic syndrome | Experimental | Membranous nephropathy and nephrotic syndrome. Receives: Drug: Apixaban |
| Atrial fibrillation | Active comparator | Atrial fibrillation with no kidney disease. Receives: Drug: Apixaban |
What is being measured
The primary outcome is the main question the study is designed to answer.
Initial Thrombin Generation Assay in nephrotic patients treated with Dalteparin
Thrombin Generation Assay is used to monitor the anticoagulation therapy
Measured: Predose on Day 1
Steady state Thrombin Generation Assay (TGA) in nephrotic patients treated with Dalteparin (Nadir TGA value)
Thrombin Generation Assay is used to monitor the anticoagulation therapy
Measured: Predose day 4
Steady state Thrombin Generation Assay (TGA) in nephrotic patients treated with Dalteparin (4 hours TGA value)
Thrombin Generation Assay is used to monitor the anticoagulation therapy
Measured: 4 hours postdose on Day 4
Initial Thrombin Generation Assay in nephrotic patients treated with Apixaban
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Measured: Predose on Day 1
Thrombin Generation Assay in nephrotic patients treated with Apixaban over the first 24 hours.
Thrombin Generation Assay is used to monitor the anticoagulation therapy with blood samples at 2.5, 8, 24 hours.
Measured: 24 hours
Steady state Thrombin Generation Assay in nephrotic patients treated with Apixaban.
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Measured: Predose day 4
Initial Thrombin Generation Assay in patients with atrial fibrillation and no kidney disease treated with Apixaban
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Measured: Predose on Day 1
Thrombin Generation Assay in patients with atrial fibrillation and no kidney disease treated with Apixaban over the first 24 hours.
Thrombin Generation Assay is used to monitor the anticoagulation therapy with blood samples at 2.5, 8, 24 hours.
Measured: 24 hours
Steady state Thrombin Generation Assay in patients with atrial fibrillation and no kidney disease treated with Apixaban.
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Measured: Predose day 4
Comparing Thrombin Generation Assay between group B and C.
Comparing Thrombin Generation Assay in nephrotic patients treated with Apixaban and patients with atrial fibrillation treated with Apixaban.
Measured: Predose, 2.5, 8, 24 hours and predose Day 4
Comparing Thrombin Generation Assay between group A and C.
Comparing Thrombin Generation Assay in nephrotic patients treated with Dalteparin and patients with atrial fibrillation treated with Apixaban.
Measured: Baseline and predose Day 4
Comparing Thrombin Generation Assay between group A and B.
Comparing Thrombin Generation Assay in nephrotic patients treated with Dalteparin and nephrotic patients treated with Apixaban.
Measured: Baseline and predose Day 4
Secondary outcomes (4)
Evaluation of bleeding-events durin the study.
Number of cases with bleeding-events.
Measured: Predose until 7 days after last dose of apixaban.
Evaluation of thromboembolic complications during the study.
Number of cases with thromboembolic complications
Measured: Predose until 7 days after last dose of apixaban.
Comparing plasma concentration of Apixaban between group B and C
Comparing plasma-Apixaban in nephrotic patients and patients with atrial fibrillation.
Measured: Day 4
Comparing urine concentration of Apixaban between group B and C
Comparing urine-Apixaban in nephrotic patients and patients with atrial fibrillation.
Measured: Day 4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Apr 2021
- Study start25 Mar 2021
- Primary completion1 May 2024
- Study completion1 May 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Nephrotic SyndromeStudies of the same condition, open and under way.
- More trials run by University of AarhusThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1/2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- An open-label, controlled, non-randomized, interventional clinical trial.
- Masking
- None (open label)
- Enrolment
- 57 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Aarhus
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Sarah Kelddal, MD, Principal investigator, Aarhus University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04850378
- Sponsor's protocol ID
- Prot-0824-2019
- Acronym
- CAPTAIN
- Status last verified
- May 2024
- First submitted
- 9 Apr 2021
- Last updated
- 11 Apr 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Kelddal S, Grove EL, Duus CL, Nygaard LB, Kristensen T, Mose FH, Gregersen JW, Hvas AM, Birn H. Apixaban Concentrations and Effects on Coagulation in Patients With Nephrotic Syndrome. Kidney Med. 2025 Oct 10;7(12):101136. doi: 10.1016/j.xkme.2025.101136. eCollection 2025 Dec.
PubMed 41333097Kelddal S, Grove EL, Duus CL, Nygaard LB, Kristensen T, Mose FH, Gregersen JW, Hvas AM, Birn H. Alterations in Coagulation and Endothelial Function in Nephrotic Syndrome: A Multicenter, Cross-Sectional Analysis. Kidney360. 2025 Nov 1;6(11):1960-1969. doi: 10.34067/KID.0000000865. Epub 2025 Jun 6.
PubMed 40478760
Study at a glance
From the registry record, last updated by the sponsor on 11 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Causes and Prevention of Thromboembolic Disease in Nephrotic Syndrome
- ClinicalTrials.gov ID
- NCT04850378
- Acronym / sponsor ID
- CAPTAIN / Prot-0824-2019
- Conditions
- Nephrotic Syndrome, Thromboembolic Disease
- Keywords
- Nephrotic Syndrome, Glomerulonephritis, Hypoalbuminemia, Proteinuria, Thromboembolic Disease, Membranous Nephropathy
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 57 participants (actual)
- Lead sponsor
- University of AarhusUniversity, hospital or other
- Study start
- 25 Mar 2021 (actual)
- Primary completion
- 1 May 2024 (actual)
- Study completion
- 1 May 2024 (actual)
- First posted
- 20 Apr 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The study aims to describe the biochemical coagulation profile and investigate the effect of Low molecular weight heparin and Apixaban on this profile in patients with nephrotic syndrome.
Detailed description
The initial part of the study is a prospective cross-sectional study which will describe the biochemical coagulation profile in nephrotic patients. It will include 60 patients with nephrotic syndrome and data from 50 anonymous blood donors matched in age and gender for comparison.
The second part of the study is an open-label, controlled, non-randomized, interventional clinical trial consisting of 3 groups of patients with nephrotic syndrome or atrial fibrillation treated with either Dalteparin or Apixaban. The study participant is expected to be in stable condition after 4 full days of treatment. For administrative reasons, the final biochemical tests are performed on day 4, 5, 6 or 7 described as day 4 in this protocol.
- Group A: Up to 50 patients with nephrotic syndrome treated with injection Dalteparin 200 Units/kg subcutaneous once a day for 4 days
- Group B: 10 patients with nephrotic syndrome and membranous nephropathy treated with Apixaban 5 mg twice daily for 4 days.
- Group C: 10 patients with atrial fibrillation and no kidney disease treated with Apixaban 5 mg twice daily for 4 days.
Patients participating in the initial part of the study will be included in det second part (Group A) if they meet the inclusion criteria. If the patient is diagnosed with membranous nephropathy it is possible to be included in the initial part as well as the second part (Group A and B).
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
- Model description
- An open-label, controlled, non-randomized, interventional clinical trial.
| Arm | Type | Receives |
|---|---|---|
| Coagulation profile in Nephrotic syndrome | No intervention | –Investigation of the biochemical coagulation profile in patients with nephrotic syndrome. |
| Nephrotic syndrome | Experimental | Drug: DalteparinNephrotic patients without diabetes. |
| Membranous nephropathy and nephrotic syndrome | Experimental | Drug: ApixabanMembranous nephropathy and nephrotic syndrome. |
| Atrial fibrillation | Active comparator | Drug: ApixabanAtrial fibrillation with no kidney disease. |
Who may qualify
- Ages
- 18 to 79 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (23 listed)
- Age 18-79 years
- Estimated Glomerular Filtration Rate (eGFR) > 49 mL/min/1.73 m2
- P-albumin < 30 g/L
- U-Albumin excretion > 2.2 g/day
- Known glomerular disease including membranous nephropathy, which may cause nephrotic syndrome or diagnostically unresolved nephrotic syndrome with a planed kidney biopsy.
Key exclusion criteria (10 listed)
- Contraindication to Apixaban
- Contraindication to Dalteparin
- Known allergy or intolerance to Apixaban
- Known allergy or intolerance to Dalteparin
- Treatment with anticoagulation for other reasons.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| DalteparinAlso: FragminDrug: Dalteparin 200 units/kg once a day for 4-7 days. | Drug | Nephrotic syndrome |
| ApixabanAlso: EliquisDrug: Apixaban 5 mg twice a day for 4-7 days. | Drug | Atrial fibrillation, Membranous nephropathy and nephrotic syndrome |
Primary outcome
Initial Thrombin Generation Assay in nephrotic patients treated with Dalteparin
Time frame: Predose on Day 1
Thrombin Generation Assay is used to monitor the anticoagulation therapy
Steady state Thrombin Generation Assay (TGA) in nephrotic patients treated with Dalteparin (Nadir TGA value)
Time frame: Predose day 4
Thrombin Generation Assay is used to monitor the anticoagulation therapy
Steady state Thrombin Generation Assay (TGA) in nephrotic patients treated with Dalteparin (4 hours TGA value)
Time frame: 4 hours postdose on Day 4
Thrombin Generation Assay is used to monitor the anticoagulation therapy
Initial Thrombin Generation Assay in nephrotic patients treated with Apixaban
Time frame: Predose on Day 1
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Thrombin Generation Assay in nephrotic patients treated with Apixaban over the first 24 hours.
Time frame: 24 hours
Thrombin Generation Assay is used to monitor the anticoagulation therapy with blood samples at 2.5, 8, 24 hours.
Steady state Thrombin Generation Assay in nephrotic patients treated with Apixaban.
Time frame: Predose day 4
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Initial Thrombin Generation Assay in patients with atrial fibrillation and no kidney disease treated with Apixaban
Time frame: Predose on Day 1
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Thrombin Generation Assay in patients with atrial fibrillation and no kidney disease treated with Apixaban over the first 24 hours.
Time frame: 24 hours
Thrombin Generation Assay is used to monitor the anticoagulation therapy with blood samples at 2.5, 8, 24 hours.
Steady state Thrombin Generation Assay in patients with atrial fibrillation and no kidney disease treated with Apixaban.
Time frame: Predose day 4
Thrombin Generation Assay is used to monitor the anticoagulation therapy.
Comparing Thrombin Generation Assay between group B and C.
Time frame: Predose, 2.5, 8, 24 hours and predose Day 4
Comparing Thrombin Generation Assay in nephrotic patients treated with Apixaban and patients with atrial fibrillation treated with Apixaban.
Comparing Thrombin Generation Assay between group A and C.
Time frame: Baseline and predose Day 4
Comparing Thrombin Generation Assay in nephrotic patients treated with Dalteparin and patients with atrial fibrillation treated with Apixaban.
Comparing Thrombin Generation Assay between group A and B.
Time frame: Baseline and predose Day 4
Comparing Thrombin Generation Assay in nephrotic patients treated with Dalteparin and nephrotic patients treated with Apixaban.
4 secondary outcomes
Evaluation of bleeding-events durin the study.
Time frame: Predose until 7 days after last dose of apixaban.
Evaluation of thromboembolic complications during the study.
Time frame: Predose until 7 days after last dose of apixaban.
Comparing plasma concentration of Apixaban between group B and C
Time frame: Day 4
Comparing urine concentration of Apixaban between group B and C
Time frame: Day 4
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Apr 2025.
- Derived from this study: PubMed 41333097Kelddal S, Grove EL, Duus CL, Nygaard LB, Kristensen T, Mose FH, Gregersen JW, Hvas AM, Birn H. Apixaban Concentrations and Effects on Coagulation in Patients With Nephrotic Syndrome. Kidney Med. 2025 Oct 10;7(12):101136. doi: 10.1016/j.xkme.2025.101136. eCollection 2025 Dec.
- Derived from this study: PubMed 40478760Kelddal S, Grove EL, Duus CL, Nygaard LB, Kristensen T, Mose FH, Gregersen JW, Hvas AM, Birn H. Alterations in Coagulation and Endothelial Function in Nephrotic Syndrome: A Multicenter, Cross-Sectional Analysis. Kidney360. 2025 Nov 1;6(11):1960-1969. doi: 10.34067/KID.0000000865. Epub 2025 Jun 6.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Sarah Kelddal, MD principal investigator
Aarhus University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Dalteparin and Apixaban in people with Nephrotic Syndrome and Thromboembolic Disease, run by University of Aarhus at 1 site in Denmark.
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 23 inclusion and 10 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: finished, as of the sponsor's last update on 11 Apr 2025. 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 Denmark. 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Initial Thrombin Generation Assay in nephrotic patients treated with Dalteparin (time frame: Predose on Day 1). The study lists 12 primary outcomes in all. 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 NCT04850378, which also lists 2 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 11 Apr 2025.