Omega-3 Fatty Acids That Affect the Immune System in Kidney Transplant Patients

NCT ID: NCT00047983

Last Updated: 2017-01-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

EARLY_PHASE1

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2004-04-30

Brief Summary

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The purpose of this study is to evaluate the effectiveness of nutritional supplements in increasing the amount of omega-3 fatty acids (and arginine) in the red blood cell membranes and plasma of kidney transplant patients, and, secondarily, to compare patient compliance. The long-term goal of this study is to develop low risk therapies that will allow improved and lasting survival of donor tissue with minimal suppression of the immune system.

Detailed Description

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Short-term survival rates of donor tissue after kidney transplantation have improved significantly in recent years because of improved immunosuppression. Rates of long-term tissue loss have changed less because of a high incidence of chronic rejection, infectious complications, and cardiovascular disease. Data suggest that both early and late complications might be reduced in transplant recipients by dietary intervention to raise levels of omega-3 fatty acids and arginine.

Prior to transplantation, participants are randomized to one of three groups. Group 1 participants serve as controls and receive no dietary supplements. Participants in Group 2 receive daily nutritional supplements of arginine and canola oil according to body weight. Group 3 participants receive daily nutritional supplements of arginine and a fish oil emulsion according to body weight. All participants receive a standard, low-fat dietary consultation. The status of participants is evaluated peri-transplant and at 1, 3, 6, and 9 months.

Conditions

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Kidney Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control

Controls and will receive no dietary supplements

Group Type NO_INTERVENTION

No interventions assigned to this group

Arginine and Canola Oil

Daily nutritional supplements of arginine and canola oil

Group Type EXPERIMENTAL

Canola oil

Intervention Type DIETARY_SUPPLEMENT

Arginine

Intervention Type DIETARY_SUPPLEMENT

Arginine and Coromega

Daily nutritional supplements of arginine and Coromega

Group Type EXPERIMENTAL

Arginine

Intervention Type DIETARY_SUPPLEMENT

Fish oil emulsion

Intervention Type DIETARY_SUPPLEMENT

Interventions

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Canola oil

Intervention Type DIETARY_SUPPLEMENT

Arginine

Intervention Type DIETARY_SUPPLEMENT

Fish oil emulsion

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Coromega

Eligibility Criteria

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Inclusion Criteria

* End-stage renal disease.
* Candidate to receive a living-related donor, living unrelated donor, or first cadaver kidney with at least 1 HLA mismatch.
* Negative crossmatch with the intended donor.
* Adults must have moderate to severe hypertension and/or take at least 1 medication for hypertension daily.
* Willingness to comply with the dietary supplements, including canola oil, a flavored drink mix, or an orange flavored pudding.

Exclusion Criteria

* Pregnancy or breast-feeding.
* Women of childbearing age who are not willing or able to practice acceptable methods of contraception.
* HIV-positive.
* Positive test for HBV E-AG/DNA and HCV.
* Received an organ transplant or plan to receive a multiple organ transplant.
* Phenylketonuria.
* Participation in other investigational studies within 30 days of the renal transplant.
* Allergy or anaphylactic reactions to eggs or L-arginine.
* ABO blood incompatibility.
* Children who have previously received more than 5 blood transfusions.
* History of stroke.
Minimum Eligible Age

4 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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J. W. Alexander, MD

Role: PRINCIPAL_INVESTIGATOR

University of Cincinnati

Locations

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Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

University of Maryland School of Medicine

Baltimore, Maryland, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

University of Cincinnati College of Medicine

Cincinnati, Ohio, United States

Site Status

Countries

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United States

References

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van der Heide JJ, Bilo HJ, Donker JM, Wilmink JM, Tegzess AM. Effect of dietary fish oil on renal function and rejection in cyclosporine-treated recipients of renal transplants. N Engl J Med. 1993 Sep 9;329(11):769-73. doi: 10.1056/NEJM199309093291105.

Reference Type BACKGROUND
PMID: 8350886 (View on PubMed)

Daly JM, Lieberman MD, Goldfine J, Shou J, Weintraub F, Rosato EF, Lavin P. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome. Surgery. 1992 Jul;112(1):56-67.

Reference Type BACKGROUND
PMID: 1377838 (View on PubMed)

Bower RH, Cerra FB, Bershadsky B, Licari JJ, Hoyt DB, Jensen GL, Van Buren CT, Rothkopf MM, Daly JM, Adelsberg BR. Early enteral administration of a formula (Impact) supplemented with arginine, nucleotides, and fish oil in intensive care unit patients: results of a multicenter, prospective, randomized, clinical trial. Crit Care Med. 1995 Mar;23(3):436-49. doi: 10.1097/00003246-199503000-00006.

Reference Type BACKGROUND
PMID: 7874893 (View on PubMed)

Alexander JW, Levy A, Custer D, Valente JF, Babcock G, Ogle CK, Schroeder TJ. Arginine, fish oil, and donor-specific transfusions independently improve cardiac allograft survival in rats given subtherapeutic doses of cyclosporin. JPEN J Parenter Enteral Nutr. 1998 May-Jun;22(3):152-5. doi: 10.1177/0148607198022003152.

Reference Type BACKGROUND
PMID: 9586793 (View on PubMed)

Natale P, Mooi PK, Palmer SC, Cross NB, Cooper TE, Webster AC, Masson P, Craig JC, Strippoli GF. Antihypertensive treatment for kidney transplant recipients. Cochrane Database Syst Rev. 2024 Jul 31;7(7):CD003598. doi: 10.1002/14651858.CD003598.pub3.

Reference Type DERIVED
PMID: 39082471 (View on PubMed)

Related Links

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https://www.niaid.nih.gov/

National Institute of Allergy and Infectious Diseases (NIAID)

https://www.niaid.nih.gov/about/dait

Division of Allergy, Immunology, and Transplantation (DAIT)

Other Identifiers

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DAIT ID01

Identifier Type: -

Identifier Source: org_study_id

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