Treatment of Obstructive Sleep Apnea in Chronic Kidney Disease

NCT ID: NCT02420184

Last Updated: 2022-05-23

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

NA

Total Enrollment

57 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-06-30

Study Completion Date

2021-12-31

Brief Summary

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This study is being conducted to determine whether treatment of obstructive sleep apnea (OSA) in patients with chronic kidney disease (CKD) improves kidney function. Half of the participants will receive continuous positive airway pressure (CPAP) treatment for their OSA in addition to their regular CKD treatment, while the other half will only receive their regular CKD treatment.

Detailed Description

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Obstructive sleep apnea (OSA) and associated hypoxemia during sleep have been associated with a decline in kidney function. The abnormalities in kidney function associated with OSA have been improved by treatment of OSA with continuous positive airway pressure (CPAP), which is a common and effective therapy for OSA. Up to now, clinical research on the impact of OSA on kidney function has been performed on patients without CKD. This study will examine the impact of CPAP therapy on kidney function in patients with CKD.

CKD patients with OSA and nocturnal hypoxemia will be randomized into one of two groups where half will receive treatment of their OSA with CPAP and the other half will not. All participants will have kidney function monitored every 3 months for a year by measurement of serum creatinine and proteinuria. The change in estimated glomerular filtration rate (eGFR) and proteinuria between the two groups will be assessed to determine whether treatment of OSA improves kidney function in patients with CKD.

Conditions

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Sleep Apnea, Obstructive Renal Insufficiency, Chronic

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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CPAP Therapy

Participants will receive standard medical care for CKD as well as CPAP therapy for the duration of the study (1 year).

Group Type EXPERIMENTAL

CPAP

Intervention Type DEVICE

Participants randomized into the experimental CPAP therapy arm will receive CPAP in addition to their standard medical therapy for CKD. CPAP will be worn whenever the participant sleeps for the duration of the study.

No CPAP

Participants will receive standard medical care for CKD.

Group Type PLACEBO_COMPARATOR

No CPAP

Intervention Type OTHER

Participants randomized into the placebo comparator no CPAP arm will receive standard medical therapy for CKD.

Interventions

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CPAP

Participants randomized into the experimental CPAP therapy arm will receive CPAP in addition to their standard medical therapy for CKD. CPAP will be worn whenever the participant sleeps for the duration of the study.

Intervention Type DEVICE

No CPAP

Participants randomized into the placebo comparator no CPAP arm will receive standard medical therapy for CKD.

Intervention Type OTHER

Other Intervention Names

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Respironics REMstar AutoA-Flex

Eligibility Criteria

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Inclusion Criteria

* CKD stage 3 or 4
* OSA (RDI\>5) and nocturnal hypoxemia (SaO2 \<90% for \>12% of night)

* Current therapy with CPAP or supplemental oxygen
* Severe daytime sleepiness reflected by an Epworth Sleepiness Score \>15
* Any driver who holds a commercial drivers' license or who reports a recent history (past 6 months) of a road traffic accident
* Severe nocturnal hypoxemia reflected by mean SaO2 \<80% during level 3 sleep testing
* Daytime hypoxemia reflected by partial pressure of oxygen in arterial blood (PaO2) less than 60 millimetres of mercury (mmHg) during wakefulness
* Hypoventilation reflected by partial pressure of carbon dioxide in arterial blood (PaCO2) greater than 45 millimetres of mercury (mmHg) during wakefulness
* Central sleep apnea that accounts for \>50% of the estimated RDI
* Unable to provide informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

76 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Calgary

OTHER

Sponsor Role lead

Responsible Party

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Dr. Patrick Hanly

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Patrick J Hanly, MD

Role: PRINCIPAL_INVESTIGATOR

University of Calgary

References

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Rimke AN, Ahmed SB, Turin TC, Pendharkar SR, Raneri JK, Lynch EJ, Hanly PJ. Effect of CPAP Therapy on Kidney Function in Patients With Chronic Kidney Disease: A Pilot Randomized Controlled Trial. Chest. 2021 May;159(5):2008-2019. doi: 10.1016/j.chest.2020.11.052. Epub 2020 Dec 13.

Reference Type DERIVED
PMID: 33316238 (View on PubMed)

Rimke AN, Ahmed SB, Turin TC, Pendharkar SR, Raneri JK, Lynch EJ, Hanly PJ. Effect of CPAP therapy on kidney function in patients with obstructive sleep apnoea and chronic kidney disease: a protocol for a randomised controlled clinical trial. BMJ Open. 2019 Mar 23;9(3):e024632. doi: 10.1136/bmjopen-2018-024632.

Reference Type DERIVED
PMID: 30904853 (View on PubMed)

Other Identifiers

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REB15-0055

Identifier Type: -

Identifier Source: org_study_id

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