Aortic Calcification and Central Blood Pressure in Patients With Chronic Kidney Disease
NCT ID: NCT04114695
Last Updated: 2022-03-31
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
185 participants
OBSERVATIONAL
2019-10-15
2022-01-01
Brief Summary
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This study will seek to identify physiological and biochemical factors explaining and predicting a higher than expected central (aortic) blood pressure (BP) in patients with chronic kidney disease (CKD). The basic hypothesis of the study is that the degree of aortic calcification is an important component of elevated central BP, which, in turn, is important for the organ-damage and increased risk of cardiovascular disease associated with CKD.
Methods:
Adult patients with varying degrees of CKD undergoing scheduled coronary angiography (CAG) at Aarhus University Hospital will be included in this study.
During the CAG procedure, systolic and diastolic BP is determined in the ascending part of aorta by a calibrated pressure transducer connected to the fluid-filled CAG catheter.
Simultaneous with the registration of invasive aortic BP, estimation of central BP is performed using radial artery tonometry (SphygmoCor®), while a corresponding brachial BP is also measured.
Prior to the CAG, a non-contrast CT scan of aorta in its entirety will be performed to enable blinded quantification of calcification in the wall of aorta and coronary arteries.
Furthermore, echocardiography, resting BP measurement and a range of blood- and urine samples will be performed.
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Detailed Description
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Conditions
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Study Design
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COHORT
CROSS_SECTIONAL
Study Groups
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Non-CKD (eGFR >60 ml/min/1.73 m2)
Patients with renal function considered normal for age (eGFR \>60 ml/min/1.73 m2) without proteinuria or structural kidney disease.
No interventions assigned to this group
CKD stage 3a (eGFR 45-59 ml/min/1,73 m2)
Patients with CKD stage 3a (eGFR 45-59 ml/min/1,73 m2)
No interventions assigned to this group
CKD stage 3b (eGFR 30-44 ml/min/1,73 m2)
Patients with CKD stage 3b (eGFR 30-44 ml/min/1,73 m2)
No interventions assigned to this group
CKD stage 4 (eGFR 15-29 ml/min/1,73 m2)
Patients with CKD stage 4 (eGFR 15-29 ml/min/1,73 m2)
No interventions assigned to this group
CKD stage 5 (eGFR <15 ml/min/1,73 m2)
Patients with CKD stage 5 (eGFR \<15 ml/min/1,73 m2). 50% of these patients will be in dialysis, while the other 50% will be pre-dialysis patients.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Patient referred for planned CAG at the Department of Cardiology, Aarhus University Hospital (AUH)
* eGFR constantly either \>60 ml/min or \<60 ml/min in at least 2 separate blood-sample measurements over at least 3 months.
* Signed informed consent-form.
Exclusion Criteria
* Severe aortic valve stenosis (\<1 cm) as central hemodynamics may be altered
* Maximum number of patients in CKD-group already reached.
* Atrial fibrillation or other cardiac arrhythmia making radial Pulse Wave Analysis (PWA) estimations impossible.
* Known significant stenosis of a. subclavia or a. brachialis
* Bilateral arteriovenous-fistula (even if one or both of these have been surgically removed) as this may significantly affect the pulse-wave form.
18 Years
ALL
No
Sponsors
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Central Jutland Regional Hospital
OTHER
Responsible Party
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Jakob Tobias Nyvad
M.D., PhD-student
Principal Investigators
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Niels H Buus, MD PhD DMSc
Role: STUDY_CHAIR
Department of Renal diseases, Aarhus University Hospital
Jakob T Nyvad, M.D.
Role: PRINCIPAL_INVESTIGATOR
The Clinic of Hypertension, Aarhus University Hospital
Locations
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Aarhus University Hospital
Aarhus, , Denmark
Countries
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References
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Nyvad J, Christensen KL, Andersen G, Reinhard M, Norgaard BL, Madsen JS, Nielsen S, Thomsen MB, Jensen JM, Peters CD, Buus NH. PIVKA-II but not dp-ucMGP is associated with aortic calcification in chronic kidney disease. BMC Nephrol. 2024 Nov 27;25(1):426. doi: 10.1186/s12882-024-03876-5.
Nyvad J, Christensen KL, Andersen G, Reinhard M, Maeng M, Nielsen S, Thomsen MB, Jensen JM, Norgaard BL, Buus NH. Aortic Calcification is Associated With the Difference Between Invasive Central and Cuff-Measured Brachial Blood Pressure in Chronic Kidney Disease. Am J Hypertens. 2024 Jun 14;37(7):455-464. doi: 10.1093/ajh/hpae029.
Other Identifiers
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VEK-nr 66842
Identifier Type: -
Identifier Source: org_study_id
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