Trace Element Replenishment Study in Hemodialysis Patients
NCT ID: NCT01473914
Last Updated: 2016-12-16
Study Results
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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COMPLETED
PHASE3
150 participants
INTERVENTIONAL
2012-11-30
2014-01-31
Brief Summary
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The primary objective is to compare two doses (medium and high) of the new supplement with the renal vitamin currently being prescribed to people with End Stage Renal Disease (ESRD).
Secondary objective is to demonstrate the feasibility of recruitment for a definitive larger trial.
Detailed Description
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Recent evidence (including our work; see http://www.biomedcentral.com/bmcmed/subjects/nephrology) indicates that people with severe kidney disease are often deficient in several other biologically essential substances (selenium, zinc) that are readily amenable to supplementation. Pilot data from the Northern Alberta Renal Program (NARP) indicate that approximately 90% of patients have zinc levels below the lower limit of normal; findings for selenium are similar.
Potential benefits of zinc supplementation include improvements in immune function, taste sensitivity (perhaps reducing dietary sodium intake), and improved appetite. Potential benefits of selenium supplementation include reductions in the risk of vascular disease and infection. Supplementation with vitamin E was shown in a randomized trial to reduce serious cardiovascular morbidity in people with kidney failure, but is not routinely used in dialysis patients. This suggests that supplementation of zinc, selenium, and vitamin E has theoretical benefits in kidney failure. Since patients with kidney failure already take many medications, it is logical to combine any new nutritional supplements with the ingredients of the standard renal vitamin to reduce pill burden.
This protocol concerns a novel nutritional supplement consisting of zinc, selenium and vitamin E in addition to the contents of the standard renal supplement of B and C vitamins.
This pilot randomized, double blind trial will compare 2 doses of the new supplement with the standard renal vitamin.
2.0 Objectives: Primary objective: compare two formulations of the new supplement (low and medium doses of zinc and selenium) with standard treatment (Replavite or equivalent renal vitamin).
Secondary objective: demonstrate the feasibility of recruitment for a definitive larger trial
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Low dose
Standard renal vitamin plus low dose zinc and selenium plus vitamin E
1 capsule p.o, daily
Low dose: supplemental zinc, selenium and vitamin E
1. ZINC 25mg (AS ZINC SULFATE)
2. SELENIUM 50 mcg (AS SODIUM SELENITE)
3. VITAMIN E (D-ALPHA-TOCOPHEROL) (AS SUCCINATE) 250 IU
Standard renal vitamin: B and C renal vitamin
1. BIOTIN 300 MCG
2. D-PANTOTHENIC ACID (CALCIUM D-PANTOTHENATE) 10 MG
3. FOLIC ACID 1 MG
4. NIACINAMIDE 20 MG
5. VITAMIN B1 (THIAMINE MONONITRATE) 1.5 MG
6. VITAMIN B12(CYANOCOBALAMIN) 6 MCG
7. VITAMIN B2 (RIBOFLAVIN) 1.7 MG
8. VITAMIN B6 (PYRIDOXINE HYDROCHLORIDE) 10 MG
9. VITAMIN C (ASCORBIC ACID) 100 MG
10. INERT FILLER (CORNSTARCH)
Medium dose
Standard renal vitamin plus medium doses of zinc and selenium plus vitamin E
1 capsule p.o, daily
Standard renal vitamin: B and C renal vitamin
1. BIOTIN 300 MCG
2. D-PANTOTHENIC ACID (CALCIUM D-PANTOTHENATE) 10 MG
3. FOLIC ACID 1 MG
4. NIACINAMIDE 20 MG
5. VITAMIN B1 (THIAMINE MONONITRATE) 1.5 MG
6. VITAMIN B12(CYANOCOBALAMIN) 6 MCG
7. VITAMIN B2 (RIBOFLAVIN) 1.7 MG
8. VITAMIN B6 (PYRIDOXINE HYDROCHLORIDE) 10 MG
9. VITAMIN C (ASCORBIC ACID) 100 MG
10. INERT FILLER (CORNSTARCH)
Medium dose: supplemental zinc, selenium and vitamin E
1. ZINC 50 mg (AS ZINC SULFATE)
2. SELENIUM 75 mcg (AS SODIUM SELENITE)
3. VITAMIN E (D-ALPHA-TOCOPHEROL) (AS SUCCINATE) 250 IU
Standard treatment
Standard renal vitamin
1 capsule p.o, daily
Standard renal vitamin: B and C renal vitamin
1. BIOTIN 300 MCG
2. D-PANTOTHENIC ACID (CALCIUM D-PANTOTHENATE) 10 MG
3. FOLIC ACID 1 MG
4. NIACINAMIDE 20 MG
5. VITAMIN B1 (THIAMINE MONONITRATE) 1.5 MG
6. VITAMIN B12(CYANOCOBALAMIN) 6 MCG
7. VITAMIN B2 (RIBOFLAVIN) 1.7 MG
8. VITAMIN B6 (PYRIDOXINE HYDROCHLORIDE) 10 MG
9. VITAMIN C (ASCORBIC ACID) 100 MG
10. INERT FILLER (CORNSTARCH)
Interventions
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Low dose: supplemental zinc, selenium and vitamin E
1. ZINC 25mg (AS ZINC SULFATE)
2. SELENIUM 50 mcg (AS SODIUM SELENITE)
3. VITAMIN E (D-ALPHA-TOCOPHEROL) (AS SUCCINATE) 250 IU
Standard renal vitamin: B and C renal vitamin
1. BIOTIN 300 MCG
2. D-PANTOTHENIC ACID (CALCIUM D-PANTOTHENATE) 10 MG
3. FOLIC ACID 1 MG
4. NIACINAMIDE 20 MG
5. VITAMIN B1 (THIAMINE MONONITRATE) 1.5 MG
6. VITAMIN B12(CYANOCOBALAMIN) 6 MCG
7. VITAMIN B2 (RIBOFLAVIN) 1.7 MG
8. VITAMIN B6 (PYRIDOXINE HYDROCHLORIDE) 10 MG
9. VITAMIN C (ASCORBIC ACID) 100 MG
10. INERT FILLER (CORNSTARCH)
Medium dose: supplemental zinc, selenium and vitamin E
1. ZINC 50 mg (AS ZINC SULFATE)
2. SELENIUM 75 mcg (AS SODIUM SELENITE)
3. VITAMIN E (D-ALPHA-TOCOPHEROL) (AS SUCCINATE) 250 IU
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Age greater or equal to 18 years
3. Receiving Replavite or equivalent renal vitamin at baseline
4. Receiving 3 dialysis treatments per week
Exclusion Criteria
2. Pregnancy, kidney transplantation, a dialysis modality switch, or gastrointestinal surgery planned within 6 months
3. Known allergy to corn starch
4. Known allergy to zinc, selenium, vitamin E or renal vitamin.
5. Projected life expectancy of \<6 months
6. Any other conditions or procedures that, in the opinion of the investigator, would impede absorption of the study product.
7. Participants already taking a vitamin E, zinc or selenium supplement (alone or included in another multi-vitamin).
8. Individuals with a history of head or neck cancer in the past 5 years.
9. Ostomy or short gut syndrome.
10. Enroll in another (interventional) trial.
18 Years
ALL
No
Sponsors
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Alberta Health services
OTHER
Marcello Tonelli
OTHER
Responsible Party
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Marcello Tonelli
MD, Professor
Principal Investigators
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Marcello A Tonelli, MD
Role: PRINCIPAL_INVESTIGATOR
University of Alberta
Locations
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University of Calgary
Calgary, Alberta, Canada
University of Alberta
Edmonton, Alberta, Canada
Countries
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References
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Tonelli M, Wiebe N, Thompson S, Kinniburgh D, Klarenbach SW, Walsh M, Bello AK, Faruque L, Field C, Manns BJ, Hemmelgarn BR; Alberta Kidney Disease Network. Trace element supplementation in hemodialysis patients: a randomized controlled trial. BMC Nephrol. 2015 Apr 11;16:52. doi: 10.1186/s12882-015-0042-4.
Colombijn JM, Hooft L, Jun M, Webster AC, Bots ML, Verhaar MC, Vernooij RW. Antioxidants for adults with chronic kidney disease. Cochrane Database Syst Rev. 2023 Nov 2;11(11):CD008176. doi: 10.1002/14651858.CD008176.pub3.
Related Links
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Published open access article with final results
Other Identifiers
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TRSV1
Identifier Type: -
Identifier Source: org_study_id