Effect of Low Protein Diet on Top of Dapagliflozin on Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus

NCT ID: NCT06281899

Last Updated: 2024-02-28

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-01

Study Completion Date

2025-03-31

Brief Summary

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This is a prospective multicenter randomized controlled trial with a total duration of 36 months aiming to evaluate the effectiveness and the safety of low protein diet on top of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and renin-angiotensin-aldosterone inhibitors (RAASi) in reducing the progression of chronic kidney disease in patients with type 2 Diabetes Mellitus

Detailed Description

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The KDIGO Diabetes in CKD Guideline (2020) recommends the use of SGLT2i (level 1A) and suggests (level 2C) the prescription of plant protein-based low-protein diet in patients with chronic kidney disease (CKD) and diabetes mellitus (DM). Both interventions have shown synergistic nephroprotective effects, slowing the progression of chronic kidney disease by reducing glomerular hyperfiltration and proteinuria, thus resulting the hypothesis that by combining these two interventions it could be possible to achieve a superior control over the progression of diabetic kidney disease.

The nutritional intervention will consist in a mild protein restriction (0.6 g/kg dry ideal body weight) and a total recommended energy intake of 30-35 kcal/kg of ideal dry body weight per day in all patients. The protein intake will be checked through the food diary and calculated based on urea from 24 hours urine collection.

The efficacy and safety parameters will be evaluated during follow-up visits at month 1,2,3,6,12 and 18.

Conditions

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Chronic Kidney Diseases Type 2 Diabetes Mellitus

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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Intervention

Patients will receive a plant-based low protein diet (0.6 g proteins/kg ideal body weight per day) associated with Dapagliflozin 10 mg per day

Group Type EXPERIMENTAL

Dapagliflozin 10 mg Tab

Intervention Type DRUG

Dapagliflozin 10 mg once daily

Low protein diet

Intervention Type BEHAVIORAL

Plant based low protein diet (0.6 g/kg IBW)

Control

Patients will receive Dapagliflozin 10 mg per day

Group Type ACTIVE_COMPARATOR

Dapagliflozin 10 mg Tab

Intervention Type DRUG

Dapagliflozin 10 mg once daily

Interventions

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Dapagliflozin 10 mg Tab

Dapagliflozin 10 mg once daily

Intervention Type DRUG

Low protein diet

Plant based low protein diet (0.6 g/kg IBW)

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* age\>18 years old
* confirmed chronic kidney disease (with eGFR between 60 and 20 ml/min/1.73 m2 and/or proteinuria \>500 mg/g urinary creatinine) and confirmed type 2 Diabetes Mellitus
* stable kidney function for at least 12 weeks before enrollment (defined as decrease in eGFR \< 5 ml/min/1.73 m2/year according to KDIGO 2012 guideline)
* treatment with ACE/ARBs and/or MRAs for at least 3 months
* no previous treatment with SGLT2i
* good nutritional status
* declared and anticipated good compliance with the prescribed diet
* signed informed consent

Exclusion Criteria

* eGFR \< 25 ml/min/1.73 m2
* poorly controlled arterial blood pressure (mean BP≥145/85 mm Hg)
* class IV NYHA heart failure, recent MACE (less than 6 months)
* relevant comorbid conditions (active infections (HBV, HCV, HIV), active neoplasia, digestive diseases with malabsorption, active autoimmune diseases/ immunosuppressive therapy)
* ADPKD
* kidney transplantation with functional graft
* malnutrition: BMI\<18 kg/me, eight loss \>10% during the last 6 months, serum albumin \<3 g/dL
* feeding inability (anorexia, nausea)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sf Ioan Emergency Clinical Hospital, Nephrology and Dialysis Department, Bucharest, Romania

UNKNOWN

Sponsor Role collaborator

Dr Carol Davila Teaching Hospital of Nephrology, Nephrology Department, Bucharest, Romania

UNKNOWN

Sponsor Role collaborator

Carol Davila University of Medicine and Pharmacy

OTHER

Sponsor Role collaborator

Anemia Working Group Romania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Liliana Garneata, Professor

Role: PRINCIPAL_INVESTIGATOR

Carol Davila University of Medicine and Pharmacy Bucharest, Romania

Locations

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Carol Davila University of Medicine and Pharmacy Bucharest

Bucharest, , Romania

Site Status RECRUITING

Countries

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Romania

Central Contacts

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Liliana Garneata, Professor

Role: CONTACT

+40722619358

Elena Cuiban, PhD student

Role: CONTACT

+40748975315

Facility Contacts

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Liliana Garneata, Assoc Prof

Role: primary

+40722619358

Elena Cuiban, MD

Role: backup

+40748975315

Other Identifiers

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01/2022

Identifier Type: -

Identifier Source: org_study_id

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