End-Stage Renal Disease Clinical Trial
Official title:
Determination of FDF-23 Levels in Non-suppressible PTH Secretion and the Influence of Inflammation on Fetuin A Levels During Hemodialysis Treatment
The purpose of this study is to determine how levels of this newly-discovered hormone,
called FGF-23, changes in the blood in response to a high calcium dialysis bath during a
hemodialysis (HD) treatment, and how this relates to changes in the calcium and PTH levels.
We are also studying the effects of dialysis and inflammation on the levels of Fetuin A.
We intend to prospectively study a cohort of end stage renal disease (ESRD) patients on
hemodialysis in order to determine whether FDF-23 levels independently affect
non-suppressible PTH levels. The relationship between Fetuin A and inflammatory markers will
also be determined. By dialyzing patients on 3.5 mEq/L calcium dialysate bath, we seek any
relationship between ionized calcium, FGF-23 and PTH.
The goal of this study is to ascertain whether there is a regulatory relationship between
the novel phosphorus-regulating polypeptide fibroblast growth factor-23 (FGF-23), ionized
calcium (iCa), and parathyroid hormone (PTH) levels. In addition, we will determine if there
is an inverse relationship between Fetuin A levels and inflammatory markers, interleukin 6
(IL-6) and C-reactive protein (CRP), during a hemodialysis treatment.
All patients participating in this study will be off Zemplar and/or Sensipar for a washout
period of approximately 4 weeks as these medications will interfere with the study. Patients
will go through one designated research hemodialysis time for a blood draw. Blood draws will
be taken during 4 separate intervals at 0, 45, 90 and 150 minutes. At each interval, 4 tubes
of blood will be drawn.
There are no further required blood draws once each designated research HD session has been
completed. At the conclusion of the designated research HD session, vitamin D analogue
(Zemplar®) and/or Cinacalcet (Sensipar®) will be restarted, and the dose will be adjusted to
reflect the subject's recent biochemical markers (Ca, Phos, and iPTH).
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Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Basic Science
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