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Sponsored by: |
Southeast Renal Research Institute |
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Information provided by: | Southeast Renal Research Institute |
ClinicalTrials.gov Identifier: | NCT00502268 |
Arterial calcification within the coronaries and other vessels is greatly accelerated among patients with chronic or end-stage kidney disease. The mechanisms leading to increased calcification are unknown, but include hyperphosphatemia, hyperparathyroidism and altered vitamin D metabolism. Moreover, recent data demonstrates that circulating carboxy fragments of PTH (7-84) are physiologic antagonists of intact PTH (1-84) and may directly contribute to vascular calcification. Current PTH assays no not distinguish between intact and carboxy PTH fragments leading to an overestimation of intact PTH levels. Because second generation PTH assays detect both 1-84 and 7-84 PTH fragments, the use of vitamin D analogues to treat secondary hyperparathyroidism could lead to excessive suppression of 1-84 and a preponderance of carboxy PTH fragments. Moreover, increased administration of vitamin D analogues amy contribute to vascular calcifications. To investigate these questions, we plan to investigate the effect of managing new ESRD patients using conventional and third generation PTH assays on vitamin D administration and the development of coronary calcification. Hypothesis #1: Clinical management of secondary hyperparathyroidism in new hemodialysis patients using the Scantibodies 1-84/7-84 PTH ratio for one year will reduce the amount of Vitamin D administration resulting in reduced coronary calcification compared to patients in which PTH management is accomplished by conventional, second generation PTH assay.
Condition | Intervention | Phase |
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Coronary Calcification Endstage Renal Disease Parathyroid Hormone |
Other: Group 1: 2nd Generation PTH assay and DOQI guidelines for PTH management Other: Group 2-Scantibodies PTH assay |
Phase IV |
Study Type: | Interventional |
Study Design: | Prevention, Randomized, Single Blind (Subject), Active Control, Single Group Assignment, Efficacy Study |
Official Title: | A Prospective, Randomized, Open-Label Trial Investigating the Effect of 1 Alpha Hydroxy Vitamin D2 on the Development of Coronary Calcification in New ESRD Patients Using the 1-84/7-84 PTH Ratio to Determine Dosing |
Estimated Enrollment: | 50 |
Study Start Date: | February 2008 |
Estimated Study Completion Date: | July 2009 |
Estimated Primary Completion Date: | February 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Group 1: Placebo Comparator
Doxercalciferol administration by DOQI and 2nd Gen PTH assay
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Other: Group 1: 2nd Generation PTH assay and DOQI guidelines for PTH management
Doxercalciferol will be administered to maintain PTH between 150-300 pg/ml
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Group 2: Active Comparator
Doxercalciferol administered by 1-84-7-84 ratio between 1.4-1.6
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Other: Group 2-Scantibodies PTH assay
Hectorol administration maintaining 1-84/7-84 PTH assay between 1.4-1.6
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Ages Eligible for Study: | 18 Years to 80 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: James A Tumlin, MD | 704-927-1757 | jtumlin@emory.edu |
Contact: Kelly Fields, BA | 704-927-1757 | kelly.fields@SoutheastRenal.com |
United States, North Carolina | |
Davita East Charlotte Dialysis Unit | Recruiting |
Charlotte, North Carolina, United States, 28208 | |
Contact: Donna Seagrave, RN 704-531-1990 | |
Contact: Miranda Brown 704-927-1751 Miranda.Brown@southeastrenal.com | |
Principal Investigator: James A Tumlin, MD |
Principal Investigator: | James A. Tumlin, MD | Southeast Renal Research Institute |
Responsible Party: | Southeast Renal Research Institute ( James A. Tumlin MD ) |
Study ID Numbers: | SBPTH-CC1 |
Study First Received: | July 16, 2007 |
Last Updated: | February 14, 2008 |
ClinicalTrials.gov Identifier: | NCT00502268 History of Changes |
Health Authority: | United States: Institutional Review Board |
Coronary Calcification Endstage Renal Disease Parathyroid hormone |
Renal Insufficiency Metabolic Diseases Ergocalciferol Benzocaine Kidney Failure, Chronic Ergocalciferols Trace Elements Bone Density Conservation Agents Hormones Calcinosis 1 alpha-hydroxyergocalciferol |
Vitamin D Vitamin D2 Urologic Diseases Renal Insufficiency, Chronic Vitamins Calciferol Micronutrients Kidney Diseases Metabolic Disorder Kidney Failure |
Renal Insufficiency Metabolic Diseases Growth Substances Physiological Effects of Drugs Kidney Failure, Chronic Ergocalciferols Bone Density Conservation Agents Pharmacologic Actions Calcinosis |
Calcium Metabolism Disorders 1 alpha-hydroxyergocalciferol Vitamin D Urologic Diseases Renal Insufficiency, Chronic Vitamins Micronutrients Kidney Diseases Kidney Failure |