P-cresol: Correlation With Glomerular Filtration Rate and Outcome in Chronic Kidney Disease

NCT ID: NCT00888030

Last Updated: 2012-09-06

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

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2006-05-31

Study Completion Date

2011-12-31

Brief Summary

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End-stage renal disease is a global epidemia with an estimated incidence of 7% per year and high morbidity-mortality rate. Early detection of chronic kidney disease (CKD) and intervention for CKD complication is important to retard renal progression. However, "traditional uremic toxin" or "small water-soluble molecules" are poorly correlated with the renal function, uremic symptoms and outcomes of CKD patients.

Putative protein-bound solute, p-cresol, is accumulated in ESRD patients receiving dialysis therapy. This uremic solute was associated with endothelial dysfunction, immune dysregulation and can predict outcome in hemodialysis patient. P-cresol inhibits endothelial cell proliferation and endothelial response to inflammatory cytokines. In vitro, p-cresol decreases leukocyte transendotherliar migratory function and inhibit production of phagocyte reactive species. Clinically, p-cresol plays a pathophysiological role in the uremic toxicity. High free serum level of p-cresol is associated with mortality in hemodialysis patients.

Information of p-cresol in CKD patients is not available. The investigators hypothesized p-cresol can be accumulated in early CKD and have a positive correlation with the morbidity- mortality of CKD patients.

Value of p-cresol in different stages of CRF is still unknown. Information of p-cresol in CKD patients is not available. The investigators hypothesized p-cresol can be accumulated in early CKD and have a positive correlation with the morbidity- mortality of CKD patients.

The principal aim of this prospective cohort study is to investigate the association between total serum levels of p-cresol and the glomerular filtration rate. The correlation of level of p-cresol and morbidity-mortality in CKD patients will be also evaluated.

To determine the relationship, patients of nephrology clinic with a diagnosis of CKD were enrolled in this prospective study and follow-up for 1-year period. The association between total and free serum levels of p-cresol and the glomerular filtration rate were evaluated in CKD patients. The p-cresol level was correlated with other many inflammatory markers (white blood cell counts, ferritin, hs-crp, leptin) and also with the hospitalization rate secondary to cardiovascular and infectious event. The renal outcome and all-cause mortality was assessed. Determination of this relationship can help to establish an accurate marker for early detection of CKD and also its prognostic role in CKD patients.

Detailed Description

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Conditions

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Risk Factors Renal Progression Death

Keywords

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p-cresol indoxyl sulfate chronic kidney disease outcome

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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2

CKD patients with normal p-cresol

there are no interventions currently listed for this study

Intervention Type OTHER

3

CKD patient with normal indoxyl sulfate

there are no interventions currently listed for this study

Intervention Type OTHER

4

CKD patients with high indoxyl sulfate

there are no interventions currently listed for this study

Intervention Type OTHER

1

CKD patients with high p cresol

there are no interventions currently listed for this study

Intervention Type OTHER

Interventions

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there are no interventions currently listed for this study

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All CKD patients attended at out-patient department of nephrology were included for analysis.
* Estimated GFR or CCR \< 60 ml/min
* No spontaneous renal improvement or progression in past 3 months.

Exclusion Criteria

* Recent cardiovascular disease (Coronary artery disease, myocardial ischemia, cerebrovascular disease or peripheral artery disease) in past 3 months
* Recent infections requiring admission in past 3 months
* Uncontrolled hypertension
* Serum albumin level \< 2.5mg/dL
* Unwilling to participate in the trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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iwenwu

Attending physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Iwen Wu, MD

Role: PRINCIPAL_INVESTIGATOR

Chang Gung Memorial Hospital

Locations

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Department of Nephrology,Chang Gung Memorial Hospital

Keelung, , Taiwan

Site Status

Countries

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Taiwan

References

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Meijers BK, Bammens B, De Moor B, Verbeke K, Vanrenterghem Y, Evenepoel P. Free p-cresol is associated with cardiovascular disease in hemodialysis patients. Kidney Int. 2008 May;73(10):1174-80. doi: 10.1038/ki.2008.31. Epub 2008 Feb 27.

Reference Type BACKGROUND
PMID: 18305466 (View on PubMed)

Atoh K, Itoh H, Haneda M. Serum indoxyl sulfate levels in patients with diabetic nephropathy: relation to renal function. Diabetes Res Clin Pract. 2009 Feb;83(2):220-6. doi: 10.1016/j.diabres.2008.09.053. Epub 2008 Nov 22.

Reference Type BACKGROUND
PMID: 19027976 (View on PubMed)

Meijers BK, de Loor H, Verbeke K, Evenepoel P. p-Cresol for better or worse: but what are we measuring? Kidney Int. 2006 Jul;70(1):232; author reply 232-3. doi: 10.1038/sj.ki.5001530. No abstract available.

Reference Type BACKGROUND
PMID: 16810293 (View on PubMed)

Other Identifiers

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IWW-0003

Identifier Type: -

Identifier Source: org_study_id