Tocopherols and Alpha Lipoic Acid Treatment Chronic Kidney Disease (TALAT)
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Purpose
Oxidative stress and acute phase inflammation are now recognized to be highly prevalent in both the chronic kidney disease (CKD; pre-dialysis) and end stage renal disease (ESRD; on hemodialysis) populations, and several lines of evidence point to their contribution in the development of atherosclerosis. Biomarkers of the inflammatory state such as C-reactive protein (CRP) and interleukin-6 are robust predictors of cardiovascular events and death in these two populations. The uremic state is characterized by retention of oxidized solutes including reactive aldehyde groups and oxidized thiol groups. It has recently been demonstrated that initiation of maintenance hemodialysis does not improve biomarkers of oxidative stress or inflammation, suggesting that dialysis alone is inadequate to control the atherosclerotic uremic metabolic state. In this study we hypothesize that administration of antioxidant therapy will decrease biomarkers of acute phase inflammation and oxidative stress in patients with Stage III and IV CKD.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Kidney Disease |
Drug: Alpha, gamma, beta, and delta (mixed) tocopherols Drug: alpha lipoic acid Drug: placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Tocopherols and Alpha Lipoic Acid Treatment Chronic Kidney Disease (TALAT) |
- A statistically significant decrease in F2-isoprostanes, a specific oxidative stress marker [ Time Frame: 4 months ] [ Designated as safety issue: No ]
- A significant change in biomarkers of acute inflammation and oxidative stress from serum [ Time Frame: 4 months ] [ Designated as safety issue: No ]
- A significant change in brachial artery vasodilatation measured by brachial impedence plethysmography [ Time Frame: 4 months ] [ Designated as safety issue: No ]
| Enrollment: | 62 |
| Study Start Date: | March 2006 |
| Study Completion Date: | July 2007 |
| Primary Completion Date: | July 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: 1 |
Drug: Alpha, gamma, beta, and delta (mixed) tocopherols
approximately 666 IU daily (1 pill) for 4 months
Other Name: Vitamin E
Drug: alpha lipoic acid
600 mg daily (2 pills 300 mg each) for 4 months
|
| Placebo Comparator: 2 |
Drug: placebo
placebo for alpha, gamma, beta, and delta (mixed) tocopherols; 1 pill daily for 4 months
Drug: placebo
placebo for alpha lipoic acid; 2 pills daily for 4 months
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria:
- Patients with Stage III-IV chronic kidney disease measured by MDRD formula.
- age > 18 or < 75 years.
- Life expectancy greater than one year.
- Ability to understand and provide informed consent for participation in the study
Exclusion criteria:
- AIDS (HIV seropositivity is not an exclusion criteria)
- Active hepatitis C or B
- Active gout
- Other active inflammatory diseases.
- Active malignancy excluding basal or squamous cell carcinoma of the skin.
- Gastrointestinal dysfunction requiring parental nutrition.
- History of functional kidney transplant < 6 months prior to study entry.
- Anticipated live donor kidney transplant over study duration.
- Prisoners, patients will significant mental illness, pregnant women, and other vulnerable populations.
- Patients taking Vitamin E supplements > 60 IU/day, vitamin C> 500mg/day over the past 30days.
- Patients taking anti-inflammatory medication except aspirin < 325mg/day over the past 30 days.
- Patient taking any prednisone therapy.
- More than two hospitalizations within the last 90 days or one hospitalization within the last 30 days.
- On experimental drug protocols.
- Hypersensitivity to organic nitrates, isosorbide, or nitroglycerin.
- Hypersensitivity to vitamin E or alpha lipoic acid.
- Pregnant women
Contacts and Locations| United States, Maine | |
| Maine Medical Center | |
| Portland, Maine, United States, 04102 | |
| United States, Tennessee | |
| Vanderbilt University Medical Center | |
| Nashville, Tennessee, United States, 37232 | |
| Principal Investigator: | Jonathan Himmelfarb, MD | Maine Medical Center |
| Principal Investigator: | Alp Ikizler, MD | Vanderbilt University |
More Information
No publications provided
| Responsible Party: | Alp Ikizler, MD, Vanderbilt University Medical Center |
| ClinicalTrials.gov Identifier: | NCT00308971 History of Changes |
| Other Study ID Numbers: | 051000 |
| Study First Received: | March 28, 2006 |
| Last Updated: | July 8, 2009 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Kidney Diseases Renal Insufficiency, Chronic Kidney Failure, Chronic Urologic Diseases Renal Insufficiency Thioctic Acid Vitamin E Tocopherols Tocotrienols |
Antioxidants Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Protective Agents Physiological Effects of Drugs Vitamin B Complex Vitamins Micronutrients Growth Substances |
ClinicalTrials.gov processed this record on May 16, 2013