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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT03607747
Other study ID # MedAuth
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date July 18, 2018
Est. completion date August 30, 2020

Study information

Verified date January 2020
Source Aristotle University Of Thessaloniki
Contact Vasileios Vaios, MD
Phone +306984568904
Email vvaios_85@yahoo.gr
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

This study evaluates the relationship between Ambulatory Aortic and Branchial blood pressure vs Office blood pressure measurements with the changes in arterial stiffness indices, in long-term Peritoneal Dialysis (PD) patients. These parameters will be monitored both cross-sectionally at the start of the study and prospectively over a 6 month period.


Description:

All participants will be monitored over a 6 month period during which 7 monthly visits will be performed. Brachial and aortic blood pressure (BP), wave reflection and arterial stiffness indices will be assessed with the brachial cuff-based oscillometric device Mobil-O-Graph NG (IEM, Stolberg, Germany). The above hemodynamic and arterial wall parameters will be measured for 24-hours on visits 1 (baseline) and 7 (month 6). The monitor will be set to obtain recordings 3 times/hour from 11:00 pm to 06:59 am and 2 times/hour from 07:00 am to 10:59 pm. Measurements will be used for the analysis if >80% of recordings were valid with no more than two non-consecutive day hours with fewer than two valid measurements, and no more than one night hour without valid recording, according to recommendations for ambulatory BP monitoring. Bioelectrical Impendance Analysis (BIA) with the Fresenius Body Composition Monitor (BCM - Fresenius Medical Care, Bad Homberg, Germany) will be performed on visits 1, 4 and 6 in order to assess the hydration status and body composition parameters of the participants.


Recruitment information / eligibility

Status Recruiting
Enrollment 40
Est. completion date August 30, 2020
Est. primary completion date August 30, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

1. Age 18 years old or higher

2. Renal replacement therapy with Peritoneal Dialysis (Automated or Continuous Ambulatory) for at least 3 months prior to study enrollment

3. Patient to have provided informed written consent

Exclusion Criteria:

1. Ongoing atrial fibrillation

2. Hospitalization for acute myocardial infarction, unstable angina or acute ischemic stroke within the 3 previous months

3. Recent episode of PD-related peritonitis or exit site infection 1 month or less prior to study enrollment

4. Bilateral functioning or non-functioning arteriovenous fistula (AVF) and/or arteriovenous graft (AVG) used earlier for dialysis access in patients previously treated with hemodialysis

5. Body mass index (BMI) of >40 kg/m2

6. History of malignancy or any other clinical condition associated with very poor prognosis

Study Design


Locations

Country Name City State
Greece AHEPA University Hospital Thessaloniki

Sponsors (1)

Lead Sponsor Collaborator
Aristotle University Of Thessaloniki

Country where clinical trial is conducted

Greece, 

References & Publications (35)

Agarwal R, Brim NJ, Mahenthiran J, Andersen MJ, Saha C. Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy. Hypertension. 2006 Jan;47(1):62-8. Epub 2005 Dec 12. — View Citation

Agarwal R, Peixoto AJ, Santos SF, Zoccali C. Pre- and postdialysis blood pressures are imprecise estimates of interdialytic ambulatory blood pressure. Clin J Am Soc Nephrol. 2006 May;1(3):389-98. Epub 2006 Apr 12. Review. — View Citation

Agarwal R. Arterial stiffness and its relationship to clinic and ambulatory blood pressure: a longitudinal study in non-dialysis chronic kidney disease. Nephrol Dial Transplant. 2017 Nov 1;32(11):1850-1856. doi: 10.1093/ndt/gfw281. — View Citation

Asmar RG, London GM, O'Rourke ME, Safar ME; REASON Project Coordinators and Investigators. Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension. 2001 Oct;38(4):922-6. — View Citation

Atas N, Erten Y, Okyay GU, Inal S, Topal S, Öneç K, Akyel A, Çelik B, Tavil Y, Bali M, Arinsoy T. Left ventricular hypertrophy and blood pressure control in automated and continuous ambulatory peritoneal dialysis patients. Ther Apher Dial. 2014 Jun;18(3):297-304. doi: 10.1111/1744-9987.12104. — View Citation

Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness on survival in end-stage renal disease. Circulation. 1999 May 11;99(18):2434-9. — View Citation

Briet M, Boutouyrie P, Laurent S, London GM. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int. 2012 Aug;82(4):388-400. Review. — View Citation

Briet M, Collin C, Karras A, Laurent S, Bozec E, Jacquot C, Stengel B, Houillier P, Froissart M, Boutouyrie P; Nephrotest Study Group. Arterial remodeling associates with CKD progression. J Am Soc Nephrol. 2011 May;22(5):967-74. doi: 10.1681/ASN.2010080863. Epub 2011 Apr 14. — View Citation

Georgianos PI, Agarwal R. Epidemiology, diagnosis and management of hypertension among patients on chronic dialysis. Nat Rev Nephrol. 2016 Oct;12(10):636-47. doi: 10.1038/nrneph.2016.129. Epub 2016 Aug 30. Review. — View Citation

Georgianos PI, Sarafidis PA, Lasaridis AN. Arterial stiffness: a novel cardiovascular risk factor in kidney disease patients. Curr Vasc Pharmacol. 2015;13(2):229-38. Review. — View Citation

Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004 Sep 23;351(13):1296-305. Erratum in: N Engl J Med. 2008;18(4):4. — View Citation

Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation. 2001 Feb 20;103(7):987-92. — View Citation

Jang JS, Kwon SK, Kim HY. Comparison of Blood Pressure Control and Left Ventricular Hypertrophy in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). Electrolyte Blood Press. 2011 Jun;9(1):16-22. doi: 10.5049/EBP.2011.9.1.16. Epub 2011 Jun 30. — View Citation

Jung JY, Hwang YH, Lee SW, Lee H, Kim DK, Kim S, Oh YG, Yang J, Joo KW, Ahn C, Oh KH. Factors associated with aortic stiffness and its change over time in peritoneal dialysis patients. Nephrol Dial Transplant. 2010 Dec;25(12):4041-8. doi: 10.1093/ndt/gfq293. Epub 2010 May 25. — View Citation

Kimoto E, Shoji T, Shinohara K, Hatsuda S, Mori K, Fukumoto S, Koyama H, Emoto M, Okuno Y, Nishizawa Y. Regional arterial stiffness in patients with type 2 diabetes and chronic kidney disease. J Am Soc Nephrol. 2006 Aug;17(8):2245-52. Epub 2006 Jul 12. — View Citation

Koc M, Toprak A, Tezcan H, Bihorac A, Akoglu E, Ozener IC. Uncontrolled hypertension due to volume overload contributes to higher left ventricular mass index in CAPD patients. Nephrol Dial Transplant. 2002 Sep;17(9):1661-6. — View Citation

London GM, Pannier B, Guerin AP, Blacher J, Marchais SJ, Darne B, Metivier F, Adda H, Safar ME. Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol. 2001 Dec;12(12):2759-67. — View Citation

London GM, Pannier B. Arterial functions: how to interpret the complex physiology. Nephrol Dial Transplant. 2010 Dec;25(12):3815-23. doi: 10.1093/ndt/gfq614. Epub 2010 Oct 14. Review. — View Citation

Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F; Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013 Jul;31(7):1281-357. doi: 10.1097/01.hjh.0000431740.32696.cc. — View Citation

Nakahigashi M, Tsukaguchi H, Morimoto S, Nakano C, Ueda H, Someya K, Kusabe M, Kikuchi S, Imada T, Shiojima I. Determinants of the Change in Arterial Stiffness in Peritoneal Dialysis Patients. Int Heart J. 2017 Dec 12;58(6):915-925. doi: 10.1536/ihj.16-624. Epub 2017 Nov 17. — View Citation

O'Shaughnessy MM, Durcan M, Kinsella SM, Griffin MD, Reddan DN, Lappin DW. Blood pressure measurement in peritoneal dialysis: which method is best? Perit Dial Int. 2013 Sep-Oct;33(5):544-51. doi: 10.3747/pdi.2012.00027. Epub 2013 Apr 1. — View Citation

Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, Kario K, Lurbe E, Manolis A, Mengden T, O'Brien E, Ohkubo T, Padfield P, Palatini P, Pickering T, Redon J, Revera M, Ruilope LM, Shennan A, Staessen JA, Tisler A, Waeber B, Zanchetti A, Mancia G; ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens. 2008 Aug;26(8):1505-26. doi: 10.1097/HJH.0b013e328308da66. — View Citation

Protogerou AD, Argyris A, Nasothimiou E, Vrachatis D, Papaioannou TG, Tzamouranis D, Blacher J, Safar ME, Sfikakis P, Stergiou GS. Feasibility and reproducibility of noninvasive 24-h ambulatory aortic blood pressure monitoring with a brachial cuff-based oscillometric device. Am J Hypertens. 2012 Aug;25(8):876-82. doi: 10.1038/ajh.2012.63. Epub 2012 Jun 7. — View Citation

Protogerou AD, Papaioannou TG, Blacher J, Papamichael CM, Lekakis JP, Safar ME. Central blood pressures: do we need them in the management of cardiovascular disease? Is it a feasible therapeutic target? J Hypertens. 2007 Feb;25(2):265-72. Review. — View Citation

Sarafidis PA, Georgianos PI, Karpetas A, Bikos A, Korelidou L, Tersi M, Divanis D, Tzanis G, Mavromatidis K, Liakopoulos V, Zebekakis PE, Lasaridis A, Protogerou AD. Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in hemodialysis patients. Am J Nephrol. 2014;40(3):242-50. doi: 10.1159/000367791. Epub 2014 Oct 11. — View Citation

Sipahioglu MH, Kucuk H, Unal A, Kaya MG, Oguz F, Tokgoz B, Oymak O, Utas C. Impact of arterial stiffness on adverse cardiovascular outcomes and mortality in peritoneal dialysis patients. Perit Dial Int. 2012 Jan-Feb;32(1):73-80. doi: 10.3747/pdi.2010.00186. Epub 2011 Mar 31. — View Citation

Szeto CC, Kwan BC, Chow KM, Leung CB, Law MC, Li PK. Prognostic value of arterial pulse wave velocity in peritoneal dialysis patients. Am J Nephrol. 2012;35(2):127-33. doi: 10.1159/000335580. Epub 2012 Jan 11. — View Citation

Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, McAlister F, Garg AX. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol. 2006 Jul;17(7):2034-47. Epub 2006 May 31. Review. — View Citation

Townsend RR, Wimmer NJ, Chirinos JA, Parsa A, Weir M, Perumal K, Lash JP, Chen J, Steigerwalt SP, Flack J, Go AS, Rafey M, Rahman M, Sheridan A, Gadegbeku CA, Robinson NA, Joffe M. Aortic PWV in chronic kidney disease: a CRIC ancillary study. Am J Hypertens. 2010 Mar;23(3):282-9. doi: 10.1038/ajh.2009.240. Epub 2009 Dec 17. — View Citation

Utescu MS, Couture V, Mac-Way F, De Serres SA, Marquis K, Larivière R, Desmeules S, Lebel M, Boutouyrie P, Agharazii M. Determinants of progression of aortic stiffness in hemodialysis patients: a prospective longitudinal study. Hypertension. 2013 Jul;62(1):154-60. doi: 10.1161/HYPERTENSIONAHA.113.01200. Epub 2013 May 6. — View Citation

Vlachopoulos C, Aznaouridis K, O'Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010 Aug;31(15):1865-71. doi: 10.1093/eurheartj/ehq024. Epub 2010 Mar 2. Review. — View Citation

Wang MC, Tseng CC, Tsai WC, Huang JJ. Blood pressure and left ventricular hypertrophy in patients on different peritoneal dialysis regimens. Perit Dial Int. 2001 Jan-Feb;21(1):36-42. — View Citation

Wassertheurer S, Kropf J, Weber T, van der Giet M, Baulmann J, Ammer M, Hametner B, Mayer CC, Eber B, Magometschnigg D. A new oscillometric method for pulse wave analysis: comparison with a common tonometric method. J Hum Hypertens. 2010 Aug;24(8):498-504. doi: 10.1038/jhh.2010.27. Epub 2010 Mar 18. — View Citation

Weber T, Wassertheurer S, Rammer M, Maurer E, Hametner B, Mayer CC, Kropf J, Eber B. Validation of a brachial cuff-based method for estimating central systolic blood pressure. Hypertension. 2011 Nov;58(5):825-32. doi: 10.1161/HYPERTENSIONAHA.111.176313. Epub 2011 Sep 12. — View Citation

Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, Hughes AD, Thurston H, O'Rourke M; CAFE Investigators; Anglo-Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006 Mar 7;113(9):1213-25. Epub 2006 Feb 13. — View Citation

* Note: There are 35 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary 24-hour ambulatory Branchial vs office Branchial Systolic BP (SBP) as determinants of Pulse Wave Velocity 24-hour ambulatory Branchial vs office Branchial SBP: which measurement correlates stronger with the changes in Pulse Wave Velocity over a 6 month period 6 months
Secondary 24-hour ambulatory Aortic SBP vs 24-hour ambulatory Branchial SBP as determinants of Pulse Wave Velocity 24-hour ambulatory Aortic SBP vs 24-hour ambulatory Branchial SBP: which measurement correlates stronger with the changes in Pulse Wave Velocity over a 6 month period 6 months
Secondary Short-term variability of 24-hour ambulatory Branchial and Aortic SBP as a determinant of Pulse Wave Velocity Assessing the correlation between the short-term variability of 24-hour ambulatory Branchial and Aortic SBP with the changes in Pulse Wave Velocity at the start of the study and over a 6 month period 0, 6 months
Secondary Visit-to-visit variability of Branchial SBP as a determinant of Pulse Wave Velocity Assessing the predictive value of visit-to-visit variability of Branchial SBP for the changes in Pulse Wave Velocity over a 6 month period 6 months
Secondary Office blood pressure monitoring for the diagnosis of hypertension in peritoneal dialysis patients Assessing whether or not office blood pressure measurements can diagnose hypertension or control of hypertension, based on the 24-hour ambulatory recordings 0, 6 months
Secondary The effect of overhydration on 24-hour ambulatory measurements The correlation between overhydration (defined by the measurement of fluid status using Bioelectrical Impendence Analysis) and the 24-hour ambulatory Aortic and Branchial SBP measurements at the start of the study and over a 6 month period 0, 3, 6 months
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