Kidney Failure, Chronic Clinical Trial
Official title:
Case-Control Study on Analgesics and Nephropathy (SAN)
The objective of the international, multicenter case-control study was to evaluate the association between end-stage renal disease (ESRD) and use of non-phenacetin-containing analgesics with particular emphasis on combined formulations.
Background:
The association between intake of non-phenacetin-containing analgesics and the occurrence of
chronic renal failure is still controversially discussed. A new epidemiologic study was
planned and conducted in Germany and Austria.
Methods/design:
The objective of the international, multicenter case-control study was to evaluate the
association between end-stage renal disease (ESRD) and use of non-phenacetin-containing
analgesics with particular emphasis on combined formulations. A targeted sample of 1000 new
(incident) dialysis patients, aged less than 50 years, was planned to recruit between
January 1, 2001 and December 31, 2004. The age limit was chosen to avoid contamination of
the study population with phenacetin-containing analgesics to the extent possible. Four
control subjects per ESRD case, matched by age, sex, and region were selected from the
population living in the region the case came from.
Lifetime exposure to analgesics and potential renal risk factors were recorded in a single
face-to-face interview. A set of aids was introduced to reinforce the memory of study
participants.
A standardized, pre-tested interview questionnaire (participants), a medical documentation
sheet (physicians in dialysis centres), a logbook for all activities (dialysis centres) were
used to collect the necessary data.
Quality management consisted of the standardized procedures, (re-) training and supervision
of interviewers, regular checks of all incoming data for completeness and plausibility.
The study is scientifically independent and governed by a international Scientific Advisory
Committee that bridged the gap between the sponsoring companies and the investigators. Also
other advisory groups assisted the managing committee of the study. All relevant German and
Austrian nephrological associations supported the study, and the study design was carefully
reviewed and approved by the Kidney Foundation of Germany.
Discussion:
The study is expected to answer the main research question by end 2005. There is however a
high potential for various biases that we tried to address with adequate measure. One
limitation however cannot be overcome: The methodologically needed age-limitation of the
study will make it not easy to generalize the results to age groups over 50 years. It might
be suggested to repeat the study for persons over 50 years in 10 years when contamination
with phenacetin use early in life is likely to be outgrown.
;
Observational Model: Case Control, Time Perspective: Retrospective
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