Attenuation of Cardiac Effects of Arteriovenous Fistula Creation With Losartan
Recruitment status was Recruiting
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Purpose
The primary objective is to determine if the use of losartan, an angiotensin II receptor blocker, can attenuate left ventricular hypertrophy, independent of its antihypertensive effects, in patients with near end stage chronic kidney disease (CKD) who have an arteriovenous fistula created.
Secondary outcomes include the impact of the medication on BNP and hyperkalaemia
| Condition | Intervention |
|---|---|
|
Renal Failure Left Ventricular Hypertrophy |
Drug: losartan |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Prevention |
- left ventricular hypertrophy
| Estimated Enrollment: | 52 |
| Study Start Date: | October 2006 |
| Estimated Study Completion Date: | August 2008 |
Study Design: This is a prospective double blind placebo control 2 arm, randomized (1:1) parallel group study in patients with near end stage renal failure who require creation of an arteriovenous fistula for future haemodialysis. Enrolment will be over a period of 12 months. The blinded phase will be for 3 months. The study design is summarized in Appendix 1. The study consists of a screening phase, a randomization phase and a treatment phase.
Patients will be randomized into 2 groups:
- Group 1 Losartan (50mg daily blinded) and 25 mg of atenolol
- Group 2 Placebo (blinded) and 25 mg of atenolol
Patients: Patients must comply with specified inclusion and exclusion criteria. The number of patients used will be sufficient to show a 15% difference in the left ventricular mass (LVM) between the two groups
Study Endpoints: The primary endpoint is the between group difference in LVM from baseline to 1 month.
Statistical Considerations: The analysis will be based upon an 'ANCOVA'-type linear regression model that includes baseline LVM and treatment group as explanatory variables, and final LVM as the outcome variable.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of CKD at near-end stage renal failure (CKD Stage IV) ( eGFR = 15-30 mls/min).
- Age >18 years of age and <85 years of age.
- Males and post-menopausal, sterile women. Non-pregnant pre-menopausal women should be on adequate contraception and have no intention of becoming pregnant during the duration of the study.
- At baseline TTE LVEF>45%
- Willing and able to give informed consent.
Exclusion Criteria:
- Serum potassium level of more than 5.5 mmol/L
- Acute myocardial infarction or cerebrovascular accident in the previous 6 months.
- Severe uncontrolled hypertension (diastolic BP >100mmHg or systolic BP >160 mmHg)
- Evidence or suspicion of renovascular disease.
- Atrial fibrillation
- Evidence or suspicion of collagen disease, cancer, psychiatric disorder that interferes with patient compliance, drug or alcohol abuse, pregnancy, breast feeding and ineffective contraception.
Contacts and Locations| Contact: Anuradha Aggarwal, FRACP,PhD | anuradha.aggarwal@mh.org.au |
| Australia | |
| Royal Melbourne Hospital | Recruiting |
| Parkville, Australia, 3150 | |
| Contact: Anuradha Aggarwal, FrACP, PhD 93427133 anuradha.aggarwal@mh.org.au | |
| Principal Investigator: | Anuradha Aggarwal | Melbourne Health |
| Principal Investigator: | Eugenia Pedagogos, FRACP,PhD | Melbourne Health |
More Information
No publications provided by Melbourne Health
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| ClinicalTrials.gov Identifier: | NCT00602004 History of Changes |
| Other Study ID Numbers: | 2006.059 |
| Study First Received: | March 8, 2007 |
| Last Updated: | January 15, 2008 |
| Health Authority: | Australia: Human Research Ethics Committee |
Keywords provided by Melbourne Health:
|
Arteriovenous fistula hypertrophy losartan |
Additional relevant MeSH terms:
|
Arteriovenous Fistula Hypertrophy Renal Insufficiency Hypertrophy, Left Ventricular Arteriovenous Malformations Vascular Malformations Cardiovascular Abnormalities Cardiovascular Diseases Vascular Fistula Vascular Diseases Congenital Abnormalities Fistula Pathological Conditions, Anatomical |
Kidney Diseases Urologic Diseases Cardiomegaly Heart Diseases Losartan Anti-Arrhythmia Agents Cardiovascular Agents Therapeutic Uses Pharmacologic Actions Antihypertensive Agents Angiotensin II Type 1 Receptor Blockers Angiotensin Receptor Antagonists Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 21, 2013