Effect of CPAP in the Worsening of Renal Function in Early Stages of Chronic Kidney Disease (CKD)

NCT ID: NCT03319888

Last Updated: 2018-03-06

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

700 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-20

Study Completion Date

2020-05-20

Brief Summary

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Objectives: Evaluate the effect of CPAP to reduce the progression of chronic kidney disease or CKD (the decline of glomerular filtration rate is ≥ 30%) in patients with early-stage renal disease and sleep apnea syndrome (OSAS). Other objectives are; determine the prevalence of OSAS in patients with early-stage renal disease and evaluate the changes in inflamatories markers and endothelial damage, the state of KDIGO, cardiovascular events, mortality and cost-effectiveness analysis in CPAP group versus non-CPAP group patients.

Methods: A prospective, multicentric, randomized and controlled study will be carried out for 3 years. Early-stage renal disease (G1-3 KDIGO) and OSAS patients will be included. The investigators will make a respiratory polygraphy to determinate OSAS (AHI ≥15/h) and after that, the investigators randomized patients in 2 groups; CPAP group and control group (non-CPAP treatment). Patients with AHI \<15/h (non-OSAS) will be the reference group and the half of these patients, randomly chosen, will be followed up at the end of the follow up.

Statistic analysis: the investigators will analyze the differences in glomerular filtration rate before and after the treatment, comparing the percentage of patients with CKD progression for both groups. The investigators will use the chi square test with raw data and adjusted for confounding variables using intention to treat analysis with imputation of missing values.

Detailed Description

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There is a bidirectional involvement between the chronic kidney disease (CKD) and sleep apnea syndrome (OSAS). The declining of renal function, the fluid overloading and the disturbance of ventilation control could cause sleep apneas. On the other hand, the nocturnal hypoxia in patients with OSAS has been associated with changes in the renin-angiotensin system and sympathetic nervous system and production of reactive oxygen species. These findings are relationed with the deterioration of kidney function.

Conditions

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Chronic Kidney Insufficiency Sleep Apnea

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Open Label

Study Groups

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cpap group

CPAP treatment plus conservative treatment with lifestyle modifications.

Group Type EXPERIMENTAL

CPAP

Intervention Type DEVICE

continuous positive pressure in the airway

control group

Conservative treatment with lifestyle modifications.

Group Type ACTIVE_COMPARATOR

conservative treatment

Intervention Type OTHER

conservative treatment group with lifestyle modifications

Interventions

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CPAP

continuous positive pressure in the airway

Intervention Type DEVICE

conservative treatment

conservative treatment group with lifestyle modifications

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients referred to the outpatient nephrology department with a diagnosis of chronic kidney disease stages G1-3 KDIGO
* Older than18 years
* Habitual snoring or observed apneas
* Scale sleep sleepiness (Epworth Test) with 11 points or lower.

Exclusion Criteria

* Very debilitating chronic or neoplastic disease
* Respiratory failure (PaO 2 \<55 mm Hg).
* Other symptoms of suspected sleep disorder different from OSAS.
* Patients unable to perform self-administered questionnaires.
* Patients with\> 50% of central apnea or Cheyne-Stokes.
* Patients who do not sign the informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sociedad Española de Neumología y Cirugía Torácica

OTHER

Sponsor Role lead

Responsible Party

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Jaime Corral Penafiel

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Jaime Corral

Cáceres, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Jaime Corral, MD

Role: CONTACT

+34-927256204

Juan F Masa, PHD

Role: CONTACT

+34-927256204

Facility Contacts

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Jaime Corral, MD

Role: primary

927256204

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Gottlieb DJ, Punjabi NM, Mehra R, Patel SR, Quan SF, Babineau DC, Tracy RP, Rueschman M, Blumenthal RS, Lewis EF, Bhatt DL, Redline S. CPAP versus oxygen in obstructive sleep apnea. N Engl J Med. 2014 Jun 12;370(24):2276-85. doi: 10.1056/NEJMoa1306766.

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Other Identifiers

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PI15/00137

Identifier Type: -

Identifier Source: org_study_id

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