Morphological Changes of the Brain by MRI in Chronic Kidney Disease

NCT ID: NCT02827253

Last Updated: 2017-08-10

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

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-06-30

Study Completion Date

2019-06-30

Brief Summary

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The purpose of this study is to describe brain´s morphological changes induced by chronic kidney disease (CKD) in advanced stages (stages 4 and 5 defined by KDOQI guidelines) and also by haemodialysis using MRI.

Based on the hypothesis that hypotension may cause damage in some organs including brain the investigators study if intradialytic hypotension (IDH) causes any type of changes in gray and white matter of the brain.

Detailed Description

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There will be two groups: one in haemodialysis treatment and the other with chronic kidney disease patients in advanced stages (stages 4 and 5 defined by KDOQI guidelines).

Both groups will be evaluated with a MRI without contrast. A second MRI to identify brain´s morphological changes will be performed in patients of the first group a year later and in patients of the second group that will have been begun haemodialysis six months after.

In a first transverse evaluation, eighteen haemodialysis sessions from the first group will be studied with a retrospective analysis. The first three sessions of each month for six months before the MRI will be considered.

In each session the investigators will collect haemodynamic variables (systolic arterial blood pressure pre and post dialysis), intradialytic hypotension based on different definitions (Nadir90, Nadir100, Fall20, Fall30) and proper haemodialysis variables (KtV, convective transport).

In the first group and patients with CKD that will start haemodialysis, the investigators analyse the variables considered in the transverse evaluation until complete one year follow up.

Statistical analysis will be done with SPSS version 20.

Conditions

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Chronic Kidney Disease Requiring Chronic Dialysis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Predialysis

Patients with CKD (4 and 5 stages by KDOQI guidelines) underwent MRI to obtain in vivo images of brain anatomy that were subsequently analyzed by the data processing package FreeSurfer (version 5.3). A MRI 6 months after starting haemodialysis will be performed to analyze changes in gray and white matter of the brain.

MRI

Intervention Type DEVICE

MRI will be performed during interdialysis period in the haemodialysis group. MRI will be performed at the beginning of the study in predialysis group.

Haemodialysis

Patients with end stage of renal disease (ESRD) in haemodialysis underwent MRI to obtain in vivo images of brain anatomy that were subsequently analyzed by the data processing package FreeSurfer (version 5.3). A one year follow up MRI will be performed to analyze the changes in gray and white matter of the brain.

MRI

Intervention Type DEVICE

MRI will be performed during interdialysis period in the haemodialysis group. MRI will be performed at the beginning of the study in predialysis group.

Interventions

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MRI

MRI will be performed during interdialysis period in the haemodialysis group. MRI will be performed at the beginning of the study in predialysis group.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Prevalent patients of haemodialysis (6 months minimum)
* Patients with CKD (stages 4 and 5)
* Informed consent signed

Exclusion Criteria

* Refusion to participate in the study
* Presence of contraindications for MRI
* Presence of clinic neurologic disorders
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital General Universitario Gregorio Marañon

OTHER

Sponsor Role lead

Responsible Party

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Juan Manuel López Gómez, PhD

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Juan M. López Gómez, PhD

Role: STUDY_CHAIR

Hospital General Universitario Gregorio Marañon

Santiago Cedeño Mora, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital General Universitario Gregorio Marañon

Manuel Desco, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital General Universitario Gregorio Marañon

Locations

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Hospital General Universitario Gregorio Marañon

Madrid, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Juan M. López Gómez, PhD

Role: CONTACT

678 292 696

Santiago Cedeño Mora, MD

Role: CONTACT

692258295

Facility Contacts

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Juan López Gomez, PhD

Role: primary

678 292 696

Santiago Cedeño Mora, MD

Role: backup

692258295

References

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Eldehni MT, Odudu A, McIntyre CW. Randomized clinical trial of dialysate cooling and effects on brain white matter. J Am Soc Nephrol. 2015 Apr;26(4):957-65. doi: 10.1681/ASN.2013101086. Epub 2014 Sep 18.

Reference Type BACKGROUND
PMID: 25234925 (View on PubMed)

McIntyre CW, Goldsmith DJ. Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension? Kidney Int. 2015 Jun;87(6):1109-15. doi: 10.1038/ki.2015.62. Epub 2015 Apr 8.

Reference Type BACKGROUND
PMID: 25853331 (View on PubMed)

Other Identifiers

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HGUGM

Identifier Type: -

Identifier Source: org_study_id

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