Autosomal Dominant Polycystic Kidney Clinical Trial
— TRAMPOLINEOfficial title:
Treatment of Vascular Stiffness in Patients With Autosomal Dominant Polycystic Kidney Disease
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease characterized by cystic kidneys and caused by mutations in the polycystic kidney disease and other rare genes. It is associated with salt-sensitive hypertension, which accounts for the majority of morbidity and mortality. About 70% of patients with ADPKD develop hypertension, prior to the onset of kidney function decline. Early onset hypertension, despite its treatment, is independently associated with rapid kidney function decline. The investigators hypothesize that a high-sodium diet in patients with ADPKD is required for the development of vascular stiffness, which precedes hypertension, and that treatment with amiloride reverses this phenomenon.
Status | Recruiting |
Enrollment | 54 |
Est. completion date | December 31, 2024 |
Est. primary completion date | December 31, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Adults with typical ADPKD diagnosed based on Ravine criteria and/or a documented Pkd 1 or 2 mutation - Chronic kidney disease epidemiology collaboration equation estimated glomerular filtration rate =60 ml/min/1.73m2 - Ability to provide informed consent Exclusion Criteria: - Uncontrolled hypertension, defined as an office blood pressure of =160/ =90 mmHg with or without antihypertensive treatment - Concomitant use of = 3 antihypertensive medications - When antihypertensive treatment is prescribed for any other treatment indication than hypertension (e.g. cardia arrhythmia) - Serum potassium levels >5.5 mmol/L (measured within last 6 months) - History of liver disease (excluding liver cysts due to ADPKD) - History of heart failure (cardiac ejection fraction < 35%) or cardiac arrhythmia - History of diabetes mellitus - Active infection or antibiotic therapy - Immunosuppressive therapy within the last year - Concomitant use of drugs that could influence blood pressure and/or disease progression (Tolvaptan/non-steroidal anti-inflammatory drugs (NSAIDs)/chemotherapy), excluding < 3 antihypertensive drugs - Actual pregnancy or unwillingness to adhere to reproductive precautions during the duration of the study |
Country | Name | City | State |
---|---|---|---|
Netherlands | Erasmus University Medical Centre Rotterdam | Rotterdam | South-Holland |
Lead Sponsor | Collaborator |
---|---|
Erasmus Medical Center |
Netherlands,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Arterial stiffness induced by high salt diet | Difference in central arterial stiffness, measured as the pulse wave velocity (PWV), in high-salt group versus low-salt group. | At week 3, week 5 | |
Primary | Effect of treatment with amiloride on arterial stiffness in high-salt group | Difference in central arterial stiffness, measured as the pulse wave velocity (PWV), before versus after amiloride treatment in high-salt group. | At week 5 and at week 7 | |
Primary | Effect of treatment with amiloride on arterial stiffness in low-salt group | Difference in central arterial stiffness, measured as the pulse wave velocity (PWV), before versus after amiloride treatment in low-salt group. | At week 5 and at week 7 | |
Secondary | Blood pressure | 24-hours ambulatory blood pressure measurement (Mobil-O-Graph). | At week 3, week 5 and at at week 7 | |
Secondary | Salt tasting thresholds | Sodium chloride (NaCl) solutions with different concentrations to assess the salt tasting thresholds. | At inclusion, week 3, week 5 and at week 7 | |
Secondary | Skin sodium accumulation | In a subgroup of participants, tissue sodium concentration (23Na) will be assessed noninvasively using a contrast-free 23 Na-MRI scan. | At week 3, week 5 and at week 7 | |
Secondary | Markers of (vascular) inflammation and endothelial dysfunction | Blood biomaterials will be collected at the visits. We will measure inflammatory markers including the high-sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-a, and other relevant markers for endothelial dysfunction including the adhesion molecules intercellular cell adhesion molecules-1, vascular cell adhesion molecules-1 and endothelin-1. | At inclusion, week 3, week 5 and at week 7 |
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