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Trial registered on ANZCTR
Registration number
ACTRN12606000128594
Ethics application status
Approved
Date submitted
29/03/2006
Date registered
7/04/2006
Date last updated
7/04/2006
Type of registration
Prospectively registered
Titles & IDs
Public title
Salt & Hypertension & Diabetes
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Scientific title
Does habitual low dietary sodium intake augment the response to angiotensin receptor blockade and thiazide therapy in hypertensive patients with type 2 diabetes and elevated albumin excretion rate?
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 Diabetes
1093
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Hypertension
1094
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Microalbuminuria
1095
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Condition category
Condition code
Metabolic and Endocrine
1174
1174
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0
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Diabetes
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Cardiovascular
1175
1175
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0
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Hypertension
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Angiotensin 2 Receptor Agonists
Thiazide diuretics
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Intervention code [1]
962
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None
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Comparator / control treatment
Salt and placebo capsules
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Control group
Placebo
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Outcomes
Primary outcome [1]
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1. Change in ambulatory blood pressure
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Assessment method [1]
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Timepoint [1]
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From 0 to 4, 8 and from 14 to 18, 22 weeks
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Primary outcome [2]
1585
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2. Change in albumin excretion rate
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Assessment method [2]
1585
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Timepoint [2]
1585
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From 0 to 4, 8, and from 14 to 18, 22 weeks
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Secondary outcome [1]
2870
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1. Acute response of effective renal plasma flow (ERPF) to captopril.
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Assessment method [1]
2870
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Timepoint [1]
2870
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At baseline.
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Secondary outcome [2]
2871
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2. Acute response of renal resistance index (RI) to captopril.
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Assessment method [2]
2871
0
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Timepoint [2]
2871
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At baseline.
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Secondary outcome [3]
2872
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3. Fasting plasma glucose at the time of ERPF and RI measurements.
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Assessment method [3]
2872
0
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Timepoint [3]
2872
0
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Secondary outcome [4]
2873
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4. BMI.
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Assessment method [4]
2873
0
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Timepoint [4]
2873
0
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Secondary outcome [5]
2874
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5. 24 h urinary sodium, potassium and creatinine excretion.
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Assessment method [5]
2874
0
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Timepoint [5]
2874
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At 0, 4, 8, 14, 18, 22 weeks.
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Secondary outcome [6]
2875
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6. Plasma urea, creatinine and electrolytes, renin activity and aldosterone and fasting glucose and C-peptide.
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Assessment method [6]
2875
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Timepoint [6]
2875
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At 0, 4, 8, 14, 18, and 22 weeks.
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Secondary outcome [7]
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7. Haemoglobin A1C.
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Assessment method [7]
2876
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Timepoint [7]
2876
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Eligibility
Key inclusion criteria
1. Type 2 diabetes mellitus.2. Hypertension (blood pressure >140/90 or taking antihypertensive therapy).3. Albumin excretion rate > 10 µg/min (median of three consecutive measurements).4. Urinary sodium excretion either > 200 mmole/24 hr on two out of three consecutive occasions (habitual high dietary sodium intake) or < 100 mmole/24 hr on two out of three consecutive occasions (habitual low dietary sodium intake). It is proposed to study 16 patients with habitual high dietary sodium intake and 16 patients with habitual low dietary sodium intake matched for BMI. Matching for BMI will be performed because of the documented association between total caloric intake and urinary sodium excretion in the DASH study.185. Caucasian ethnicity.
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Minimum age
20
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Serum potassium > 5.0 mM.2. Serum creatinine > 200 µM.3. Albumin excretion rate > 200 µg/min.4. HbA1C > 10.0%.5. Major systemic illness.6. Drug dependence.7. Atrial fibrillation.8. Lactose intolerance (lactose capsules will be used as placebo).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Randomised by pharmacy, investigator blinded
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using procedures such as coin-tossing and dice-rolling
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/05/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
32
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Austin Health
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Address [1]
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Country [1]
1283
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Funding source category [2]
1284
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University
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Name [2]
1284
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University of Melbourne
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Address [2]
1284
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Country [2]
1284
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Primary sponsor type
Individual
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Name
Researcher Initiated Study- Professor George Jerums - Endocrine Centre of Excellence, Austin Health & University of Melbourne
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Address
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Country
Australia
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Secondary sponsor category [1]
1136
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None
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Name [1]
1136
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Nil
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Address [1]
1136
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Country [1]
1136
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
Lay Summary Project Title: Does habitual low dietary sodium intake augment the response to angiotensin receptor blockade and thiazide therapy in hypertensive patients with type 2 diabetes and elevated albumin excretion rate? Rationale: One of the complications of type 2 (adult) diabetes and high blood pressure (BP) is diabetic kidney disease. In this disorder, the kidneys leak protein (albumin) into the urine and in early stages this is known as microalbuminuria. In some patients this progressively worsens, leading to kidney failure. Some groups of blood pressure lowering medications also lower the blood pressure in the kidneys. This protects against kidney damage by slowing the progression of the protein leakage into the urine. The effectiveness of these groups of blood pressure tablets is reduced when the salt intake in the diet is high. Aims of this study: To determine if the effectiveness of the antihypertensive drug telmisartan, alone, and in combination with the drug hydrochlorothiazide, is increased by a low dietary salt (sodium chloride) intake, and if there is an additional beneficial effect on kidney function; In this study, participants with type 2 diabetes, high blood pressure and early diabetic kidney disease (microalbuminuria) will be recruited. Two groups will be compared - those who usually have a high salt intake in their diet versus those who usually have a low salt intake in their diet, as determined by previous urine sodium test results. All patients will take antihypertensive medication to control their blood pressure called verapamil, prazosin and methyldopa, these medications do not interfere with the test results. The participants will continue their usual diet and dietary salt intake throughout the study, however they will take salt and placebo capsules at various times during the study to look at the effects of additional salt intake on blood pressure and kidney function in patients with high versus those with low dietary sodium intake. Participants: The participants (n=32) includes men and non-pregnant women aged 20-80, with type 2 diabetes, high blood pressure, early diabetic kidney disease and a high or low dietary salt intake. Study Design and Procedures: Cross-over double blind study design. The study involves 12 scheduled visits over 28 weeks. The study consists of 3 phases: Two 8 week phases separated by a 6 week washout. Patients commence on verapamil ± prazosin ± methyldopa therapy and this is maintained throughout the 28 study period. The effect of telmisartan will be studied in each 8 week phase, and a thiazide will be added at week 4 to 8. The effect of salt or placebo will be examined in the last 2 weeks of each 4 week cycle. During the study, a total of approximately 210 ml (10 tablespoons) of blood will be collected. Potential side effects: There are potential side effects of blood pressure lowering medications however as all the patients have high blood pressure, they will be on blood pressure lowering medications. This study involves exposure to a very small amount of radiation during nuclear medicine MAG 3 tests to look at kidney function. This has been approved by the radiation research subcommittee. Provision of test results: Participants (and their general practitioner with their consent) will have access to all laboratory tests and when the final study report is produced by the investigator, this will be forwarded to study participants in lay terms.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
36117
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Address
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Country
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Phone
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Fax
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Email
36117
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Contact person for public queries
Name
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Dr Elif I Ekinci
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Address
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Endocrine Centre of Excellence
Heidelberg Repatriation Hospital
Austin Health
Level 2
Centaur Building
PO Box 5444
300 Waterdale Rd
West Heidelberg VIC 3081
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Country
10151
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Australia
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Phone
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+61 3 94962410
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Fax
10151
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+61 3 94963365
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Email
10151
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[email protected]
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Contact person for scientific queries
Name
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Dr Elif I Ekinci
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Address
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Endocrine Centre of Excellence
Heidelberg Repatriation Hospital
Austin Health
Level 2
Centaur Building
PO Box 5444
300 Waterdale Rd
West Heidelberg VIC 3081
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Country
1079
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Australia
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Phone
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+61 3 94962410
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Fax
1079
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+61 3 94963365
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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