Intensive Medical Treatment for Nephropathy Caused by Type 2 Diabetes With Hypertension
Recruitment status was Recruiting
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Purpose
To observe the effect of intensive medical treatment for type 2 diabetic patients with hypertension: to discover whether or not intensive medical treatment improves proteinuria, and the difference between the clinical meaning of responder and non-responder (criteria: 50% reduced proteinuria continuing 6 months or more during the observation period.)
| Condition | Intervention | Phase |
|---|---|---|
|
Type 2 Diabetes Mellitus Hypertension |
Drug: Intensive therapy Valsartan,Fluvastatin |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Intensive Medical Treatment for Nephropathy Caused by Type 2 Diabetes With Hypertension |
- Proteinuria
- Serum Creatinine
- e-GFR
- Fasting Plasma Glucose
- HbA1c
- Lipid profile
- Blood pressure
- Smoking
- Progression of renal dysfunction
- Urinary 8-OHdG,type 4 collagen,high molecular weight adiponectin
- Serum angiotensinogen
| Estimated Enrollment: | 80 |
| Study Start Date: | October 2006 |
| Estimated Study Completion Date: | March 2009 |
It is reported that the risk of a cardiovascular event occurring is 1.78 times higher in patients with diabetic nephropathy (DN) than in patients without DN. It is also reported that angiotensin II receptor blockade (ARB) prevents the progression of DN in diabetic patients with early phase nephropathy beyond its blood pressure lowering effect. The guidelines by the Japanese Society of Hypertension 2004 recommended that it was necessary to control blood pressure (BP) below 130/80 mmHg in all diabetic patients. This has become the universal target BP for the prevention of cardiovascular events in hypertensive patients. On the study of intensive medical treatment [including angiotensin-converting enzyme inhibitor (ACEI)], it is reported that ACEI not only prevents the progression of DN in microalbuminuria but also decreases proteinuria <1 g/day in the nephrotic syndrome. Therefore, ACEI is thought to be effective for DN. However, it is not clear whether or not intensive medical treatment (including ACEI) improves nephropathy with proteinuria >1 g/day.
Eligibility| Ages Eligible for Study: | 20 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Type 2 diabetic patients with hypertension, with all 5 of the criteria listed below:
- Age 20 years and above
- Blood pressure >125/75 mmHg
- Urinary protein creatinine ratio 1g/g・cr or Urinary protein >1 g/day
- Presence of diabetic retinopathy
Already performing dietary management
- There were no limitations on serum creatinine.
- BP was recorded 3 times while the patient was seated and averaged.
- The subjects in this study were outpatients with written informed consent.
Exclusion Criteria:
- Another definable renal disease other than DN
- Collagenosis
- Malignant hypertension with emergent treatment
- Severe hypertension (diastolic BP >120 mmHg)
- Severe chronic heart failure or acute myocardial infarction in the past 6 months
- Atrial fibrillation or severe arrhythmia
- Anamnesis of cerebrovascular disease with neuropathy
- Anamnesis of anaphylaxis or chronic dermatopathy
- Severe hepatic disease
- Pregnancy
- Anamnesis of anaphylaxis from angiotensin II receptor blocker
- Patients are judged to be inapposite by the attending physician
Contacts and Locations| Contact: Keiji Tanaka, MD,PhD | +81-427-778-8111 ext 8706 | keiji@med.kitasato-u.ac.jp |
| Japan | |
| Kitasato University | Recruiting |
| 1-15-1 Kitasato Sagamihara, Kanagawa, Japan, 228-8111 | |
| Contact: Keiji Tanaka +81-427-8111 ext 8706 keiji@med.kitasato-u.ac.jp | |
| Principal Investigator: Keiji Tanaka, Keiji Tanaka | |
| Study Chair: | Keiji Tanaka, MD,PhD | Kitasato University |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00407680 History of Changes |
| Other Study ID Numbers: | 8417 |
| Study First Received: | December 4, 2006 |
| Last Updated: | October 21, 2007 |
| Health Authority: | Japan: Ministry of Health, Labor and Welfare |
Keywords provided by Kitasato University:
|
Type 2 diabetes mellitus Hypertension Angiotensin II Receptor Blocker Diabetic nephropathy |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Hypertension Kidney Diseases Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Vascular Diseases Cardiovascular Diseases Urologic Diseases Fluvastatin Valsartan Angiotensin Receptor Antagonists |
Hydroxymethylglutaryl-CoA Reductase Inhibitors Anticholesteremic Agents Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Enzyme Inhibitors Lipid Regulating Agents Therapeutic Uses Angiotensin II Type 1 Receptor Blockers Antihypertensive Agents Cardiovascular Agents |
ClinicalTrials.gov processed this record on May 16, 2013