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Trial registered on ANZCTR
Registration number
ACTRN12614000049673
Ethics application status
Approved
Date submitted
6/01/2014
Date registered
17/01/2014
Date last updated
17/01/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Nitrates for bone protection in chronic kidney disease
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Scientific title
Nitrates as a potential therapeutic option for bone fragility in chronic kidney disease - a randomised, double blind placebo controlled trial
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Secondary ID [1]
283855
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Nil
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Universal Trial Number (UTN)
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Trial acronym
NITRACKD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic kidney disease
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Osteopenia
290833
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Condition category
Condition code
Musculoskeletal
291196
291196
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0
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Osteoporosis
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Renal and Urogenital
291197
291197
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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
Isosorbide dinitrate 20 mg or matching placebo once daily for 12 months as an oral tablet. Adherence will be monitored by counting of drug tablet returned.
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Intervention code [1]
288533
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Treatment: Drugs
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Comparator / control treatment
Placebo (matching microcellulose tablet)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Spinal bone mineral density (BMD), measured by dual energy x-ray absorptiometry (DXA).
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Assessment method [1]
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Timepoint [1]
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12 months
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Primary outcome [2]
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Serum alkaline phosphatase.
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Assessment method [2]
291188
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Timepoint [2]
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12 months
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Secondary outcome [1]
306204
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Femoral neck, total hip and distal radius BMD, measured by dual energy x-ray absorptiometry (DXA).
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Assessment method [1]
306204
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Timepoint [1]
306204
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12 months
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Secondary outcome [2]
306205
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Serum bone turnover markers (PINP and CTX)
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Assessment method [2]
306205
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Timepoint [2]
306205
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12 months
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Eligibility
Key inclusion criteria
Participants willl have both stage 3 or 4 CKD and either
osteopenia or osteoporosis
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Minimum age
50
Years
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Maximum age
90
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
Minimal trauma fractures
Uncorrected vitamin D deficiency (< 50 nmol/L)
PTH > 15 pmols/L
Metabolic bone diseases
Prednisolone > 5 mgs/d
Unexplained elevation of serum alkaline phosphatase
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Study design
Purpose of the study
Prevention
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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)
Patients will be randomised to active or placebo groups with stratification for sex. Recruitment into mild CKD will be limited to 20 (one third) using allocation concealment. The person who will determine if a subject is eligible for inclusion in the trial will be unaware, when this decision is made, to which group the subject will be allocated. Allocation will involve contacting the holder of the allocation schedule who will be “off-site” at a central administration site.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified, block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Safety/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
1/04/2014
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Actual
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Date of last participant enrolment
Anticipated
1/10/2015
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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
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Western Hospital - Footscray
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Recruitment hospital [2]
1895
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Sunshine Hospital - St Albans
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Recruitment postcode(s) [1]
7669
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3011 - Footscray
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Recruitment postcode(s) [2]
7670
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3021 - St Albans
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Funding & Sponsors
Funding source category [1]
288502
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Charities/Societies/Foundations
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Name [1]
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Kidney Health Australia
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Address [1]
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125 Cecil Street, South Melbourne VIC 3205
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Country [1]
288502
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Australia
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
NorthWest Academic Centre.
176 Furlong Road
St. Albans
VIC 3021
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Country
Australia
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Secondary sponsor category [1]
287207
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None
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Name [1]
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none
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Address [1]
287207
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Country [1]
287207
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
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Royal Melbourne Hospital Grattan Street Parkville VIC 3050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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29/01/2014
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Approval date [1]
290360
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Ethics approval number [1]
290360
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Summary
Brief summary
Studies have consistently shown that low trauma fractures are widely prevalent among patients with chronic kidney disease (CKD). However, the management of this condition remains controversial because the safety and efficacy of most currently available treatments for the prevention of fractures have not been adequately tested in patients with CKD. Further, many of these treatments are potentially toxic to kidneys and may also have deleterious effects in certain types renal bone disease. Therefore, there is a need for investigating new therapies for bone protection in CKD, using drugs that are safe and effective in patients with CKD. Recent evidence suggests that nitrates have all the attributes to be a potential candidate for bone protection in CKD. They have been shown to have bone protective properties in postmenopausal women, although not specifically in patients with CKD, and their safety in CKD, including in patients with advanced CKD, is well established. The current study is arandomised, placebo-controlled trail designed to assess the efficacy of isosorbide dinitrate, a commonly available oral nitrate preparation in Australia, versus placebo in the prevention of spinal bone loss in patients with moderately severe kidney disease (CKD stage 3 and 4).
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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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Prof Peter R Ebeling
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Address
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The University of Melbourne
Room 5.017, Level 3
Western Centre for Health Research and Education
Western Health
PO Box 294
176 Furlong Road
St Albans
Vic 3021
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Country
45334
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Australia
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Phone
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+61383958065
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Fax
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+61383958258
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Email
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[email protected]
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Contact person for public queries
Name
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Peter R Ebeling
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Address
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Room 5.017, Level 3
Western Centre for Health Research and Education
Western Health
PO Box 294
176 Furlong Road
St Albans
Vic 3021
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Country
45335
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Australia
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Phone
45335
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+61383958065
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Fax
45335
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+61383958258
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Email
45335
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[email protected]
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Contact person for scientific queries
Name
45336
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Peter R Ebeling
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Address
45336
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Room 5.017, Level 3
Western Centre for Health Research and Education
Western Health
PO Box 294
176 Furlong Road
St Albans
Vic 3021
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Country
45336
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Australia
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Phone
45336
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+61383958065
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Fax
45336
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+61383958258
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Email
45336
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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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