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Trial registered on ANZCTR
Registration number
ACTRN12609000543280
Ethics application status
Approved
Date submitted
3/07/2009
Date registered
6/07/2009
Date last updated
6/07/2009
Type of registration
Retrospectively registered
Titles & IDs
Public title
Does insulin have an anti-inflammatory effect in patients with end stage renal failure on haemodilaysis
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Scientific title
Does insulin reduce inflammation in patients with end stage kidney disease during a haemodialysis session?
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Secondary ID [1]
911
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Cochrane Renal Group 070800147
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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:
End stage renal failiure
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Condition category
Condition code
Renal and Urogenital
237478
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A randomised cross over study of a low dose insulin infusion (2 units/hr) during a standardised 4 hour haemodialysis session with a washout of 1 week between studies. The dialysis regime will remain unaltered between each session.
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Intervention code [1]
236866
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Treatment: Drugs
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Comparator / control treatment
A standard 4 hour haemodialysis session without an insulin infusion.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in highly sensitive C reactive protein (hsCRP) as measured in plasma at baseline, 1 hour into the dialysis session, at 4 hours at the end of the dialysis session, 2 hours after the dialysis session and at 24 hours after dialysis.
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Assessment method [1]
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Timepoint [1]
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Plasma highly sensitive C reactive protein (hsCRP) will be measured at baseline, 1 hr into dialysis, at 4 hours at the end of dilalysis, 2 hours post dialysis and 24 hours post dilalysis. HsCRP is measured by standard laboratory assay.
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Primary outcome [2]
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Inflammatory cytokines (tumor necrosis factor (TNF), interleukin 6 (IL6)) will be measured at baseline, 1 hr into dialysis, at 4 hours at the end of dilalysis, 2 hours post dialysis and 24 hours post dilalysis..Cytokines measured by enzyme linked immunoabsorbent assay (ELISA).
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Assessment method [2]
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Timepoint [2]
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Inflammatory cytokines will be measured at baseline, 1 hr into dialysis, at 4 hours at the end of dilalysis, 2 hours post dialysis and 24 hours post dilalysis.
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Primary outcome [3]
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Changes in lipid peroxidation products measured in serum using standard assays.
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Assessment method [3]
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Timepoint [3]
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Samples will be measured at baseline, 1 hr into dialysis, at 4 hours at the end of dilalysis, 2 hours post dialysis and 24 hours post dilalysis.
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Secondary outcome [1]
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NIl
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
Stable non diabetic individuals on haemodialysis for at least 2 months.
No clinical evidence of an acute illness or inflammation.
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Minimum age
18
Years
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Maximum age
65
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
Inability to give informed consent.
Diabetic
Smoker
Intercurrent acute illness or inflammation.
Established cardiovascular disease
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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)
Participants were recruited from the dialysis service.
Patients were randomly assigned to receive either dialysis with a continuous insulin infusion or to a conventional dialysis session and then subsequently switched over to the opposite treatment, with at least one week between each study. Allocation was concealed with a third party off site advising the dialysis nurses which treatment option was allocated.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization was achieved by use of a computerized randomization plan generator (www.randomization.com).
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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
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
6/08/2008
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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
12
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
1869
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New Zealand
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State/province [1]
1869
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Otago Medical Research Foundation
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Address [1]
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PO Box 1245
Dunedin 9010
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
Great King Street
PO Box 913
Dunedin 9010
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Country
New Zealand
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Dunedin Hospital
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Address [1]
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Great King Street
Private Bag
Dunedin 9010
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Country [1]
236741
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Lower South Regional Ethics Committee
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Ethics committee address [1]
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PO Box 5849 Dunedin 9010
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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06/08/2008
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Ethics approval number [1]
239356
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Summary
Brief summary
Individuals with Chronic kidney disease (CKD) requiring dialysis treatment have a high risk of cardiovascular disease. It is thought that the process of dialysis may contribute to this risk by increasing oxidative stress and inflammation. In addition, individuals with non-diabetic CKD have are insulin resistant, similar to individuals with pre-diabetes. Insulin has been demonstrated to have anti-inflammatory properties. In very sick patients in Intensive Care, continuous insulin infusions have been associated with better outcomes. The impact of an insulin infusion during a haemodialysis session to reduce the inflammation generated by dialysis has not been studied. We propose a pilot study of an insulin infusion during dialysis to see if markers of inflammation measured in the blood are reduced. If there is evidence of improvement, we would then propose a longer time study to really see if there is benefit from insulin therapy.
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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
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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
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Contact person for public queries
Name
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Prof Robert Walker
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Address
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Medical & Surgical Sciences
Dunedin School of Medicine
University of Otago
PO Box 913 Dunedin 9010
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Country
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New Zealand
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Phone
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64 3 4740999
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Fax
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64 3 4747641
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Email
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[email protected]
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Contact person for scientific queries
Name
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Prof Robert Walker
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Address
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Medical & Surgical Sciences
Dunedin School of Medicine
University of Otago
PO Box 913 Dunedin 9010
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Country
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New Zealand
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Phone
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64 3 4740999
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Fax
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64 3 4747641
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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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