Chronic Kidney Disease - Stage V Clinical Trial
— MODAIROfficial title:
Morphological and Functional Changes in White Adipose Tissue in Nondiabetic Chronic Kidney Disease Patients
Many metabolic disturbances, such as protein-energy wasting, inulin resistance, and dyslipidemia are common features of chronic kidney disease (CKD). However, to date, the underlying mechanisms of these disturbances remain elusive. Many in vitro studies have demonstrated that white adipose cells exhibit dysfunctions in conditions that mimics uremic environment. In good agreement, several animal experiments have reported that chronic kidney disease was associated with lipoatrophy, adipose tissue dysfunction and ectopic lipid redistribution. The goal of this protocol is to collect and study structural and metabolic properties of white adipose tissue in CKD stage V patients to evidence adipose tissue dysfunction associated with CKD. The primary outcome measure will be the cellularity of the adipose tissue (i.e. size of the adipose cells) and the secondary measure to study the gene expression profile using microarray and metabolic properties of adipose tissue (i.e. lipogenesis). To this end, 15 male adult volunteers and 15 non-diabetic and non-dialyzed CKD stage V patients, matched for age, gender and body mass index (BMI) will be recruited at the Departments of Nephrology or Urology of Lyon University Hospital (Lyon, France). The biopsies of abdominal subcutaneous white adipose tissue (2-3 g) will be performed during elective urologic surgery (i.e. peritoneal dialysis catheter for CKD patients and radical prostatectomy for non CKD patients).
| Status | Completed |
| Enrollment | 23 |
| Est. completion date | July 2015 |
| Est. primary completion date | July 2015 |
| Accepts healthy volunteers | No |
| Gender | Male |
| Age group | 18 Years and older |
| Eligibility |
Inclusion Criteria: CKD (Chronic Kidney Disease) and non-CKD patients: - At least 18 years of age - Able and willing to provide informed consent - Male gender - Normal fasting glucose (less than 6 mmol/l ) - No evidence of significant concurrent illness - BMI <30 kg/m2 - Non acidotic (bicarbonate >20 mmol/L) - Normal coagulation profile CKD patients: • eGFR (estimated Glomerular Filtration Rate)< 25 mL/min/m2 before the beginning of renal suppletion therapy Non-CKD patients: • eGFR >50 mL/min/m2 Exclusion Criteria: - A known diagnosis of diabetes mellitus - enrolled in a other study that may confound results of this study. - Have been treated with: corticosteroids or insulin or oral diabetic medications within 8 days prior to study entry - Unwilling and/or not able to give written consent - Patient with active systemic bacterial, viral or fungal infections |
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
| Country | Name | City | State |
|---|---|---|---|
| France | Service de Néphrologie, dialyse, hypertension artérielle - Pavillon P - Hôpital Edouard Herriot - | Lyon |
| Lead Sponsor | Collaborator |
|---|---|
| Hospices Civils de Lyon |
France,
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | Mean adipocyte size (in µm) in subcutaneous white adipose tissue removed during biopsy, measured with a Beckman Coulter | The biopsies of abdominal subcutaneous white adipose tissue (2-3 g) will be performed during elective surgery (i.e. peritoneal dialysis catheter for CKD patients and radical prostatectomy for non CKD patients). 50-100 mg will be fixed in osmium tetroxide for cellularity measurement i.e. measurement of adipose cell size. Adipose cell size will be determined by a Beckman Coulter Multisizer IV (Beckman Coulter) with a 400 µm aperture. The range of cell sizes that can effectively be measured using this aperture is 20-240 µm. The instrument will be set to count 1,000 particles, and the fixed-cell suspension will be diluted so that coincident counting remains <10%. Cell-size distributions will be drawn from measurement of at least 12,000 cell diameters for each patient. The mean fat cell volume will then be compared using Student t test or Mann & Whitney U tests. | Day 1, the day of surgery (one day after inclusion) | No |