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Trial registered on ANZCTR
Registration number
ACTRN12616000660482
Ethics application status
Approved
Date submitted
14/04/2016
Date registered
20/05/2016
Date last updated
19/05/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Levocarnitine as primary prophylaxis for intradialytic hypotension in patients with stage 5 chronic kidney disease
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Scientific title
Levocarnitine as primary prophylaxis for intradialytic hypotension in patients with stage 5 chronic kidney disease
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Secondary ID [1]
288979
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None
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Universal Trial Number (UTN)
U1111-1181-8467
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Trial acronym
ReHeMon
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
chronic renal disease
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chronic kidney disease
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hemodialysis
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Condition category
Condition code
Renal and Urogenital
298477
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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
The authors will be responsible for administering the drug: levocarnitine (LC) or placebo. Patients will be selected and then randomized in the hemodialysis unit of the University Hospital of the Autonomous University of Nuevo Leon in Monterrey, Mexico.
The following clinical intervention will take place: randomized patients will be included in the study, They will be divided into 4 groups:
Group LC0 (gLC0) - LC will be administered at a dose of 30 mg/kg/session (2 sessions/week) for a period of 12 weeks. LC will be administered at 0 minutes before the start of the hemodialysis session.
Group LC30 (gLC30) - LC will be administered at a dose of 30 mg/kg/session (2 sessions/week) for a period of 12 weeks. LC will be administered at 30 minutes before the start of the hemodialysis session.
Group P0 (gP0) - Placebo (normal saline, 5 ml/session, 2 sessions/week) will be administered for a period of 12 weeks. Placebo will be administered at 0 minutes before the start of the hemodialysis session.
Group P30 (gP30) - Placebo (normal saline, 5 ml/session, 2 sessions/week) will be administered for a period of 12 weeks. Placebo will be administered at at 30 minutes before the start of the hemodialysis session.
The drug administration will be made as follows:
Patients assigned to the gLC0 will received LC (30 mg/kg/session ) as an slow intravenous bolus (2-3 minutes) through the venous catheter line, 0 minutes before each session of hemodialysis for 12 weeks.
Patients assigned to gLC30 will received LC (30 mg/kg/session ) as an slow intravenous bolus (2-3 minutes) through the venous catheter line, 30 minutes before each session of hemodialysis for 12 weeks.
The product that will be used is levocarnitine (Efe-Carn, PISA, Mexico), injectable vial whose content is 1 g/5 mL..
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Intervention code [1]
294465
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Treatment: Drugs
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Intervention code [2]
294694
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Prevention
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Comparator / control treatment
Patients assigned to the gP0 will received normal saline (5 ml/session, 2 sessions/week) as an slow intravenous bolus (2-3 minutes) through the venous catheter line, 0 minutes before each session of hemodialysis for 12 weeks.
Patients assigned to the gP30 will received normal saline (5 ml/session, 2 sessions/week) as an slow intravenous bolus (2-3 minutes) through the venous catheter line, 30 minutes before each session of hemodialysis for 12 weeks.
We will use normal saline (PISA, Mexico) as placebo, this product is an injectable vial whose content is 0.9 g / 100 mL.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Number of episodes of intradialytic hypotension in patients with stage 5 chronic kidney disease.
Every 30 minutes, blood pressure of every patient enrolled will be assessed using a conventional sphygmomanometry and the data will be registered in mm Hg.
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Assessment method [1]
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Timepoint [1]
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12 weeks post commencement of intervention/placebo.
In every hemodialysis session blood pressure of every patient enrolled will be assessed using a conventional sphygmomanometry and the data will be registered in mm Hg, every 30 minutes,
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Secondary outcome [1]
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Percentage of episodes of intradialytic hypotension in patients with stage 5 chronic kidney disease.
Every 30 minutes, blood pressure of every patient enrolled will be assessed using a conventional sphygmomanometry and the data will be registered in mm Hg.
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Assessment method [1]
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Timepoint [1]
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12 weeks post commencement of intervention/placebo.
In every hemodialysis session blood pressure of every patient enrolled will be assessed using a conventional sphygmomanometry and the data will be registered in mm Hg, every 30 minutes,
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Secondary outcome [2]
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Quality of life measured by SF 12, SF 16, COOP/WONCA questionaries in patients with stage 5 chronic kidney disease
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Assessment method [2]
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Timepoint [2]
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12 weeks post commencement of intervention/placebo.
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Eligibility
Key inclusion criteria
Clinically stable patients; men and nonpregnant women, not breastfeeding; aged 18 to 85 years; regular attendance hemodialysis sessions at least twice a week; a minimum of 6 months on hemodialysis; and who had 2 or more episodes of intradialytic hypotension in the past 6 months.
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Minimum age
18
Years
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Maximum age
85
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
Patients who have been treated with levocarnitine in the previous 6 months; patients who have had septic shock in the previous 6 months; pregnancy; lactation; and a history of hypersensitivity or contraindication to levocarnitine.
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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)
Sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Numbers will be generated by radioactive decay.
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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
Efficacy
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Statistical methods / analysis
This is an exploratory study. Previous studies have shown no difference between groups using levocarnitine, therefore can not be used to calculate sample size. The calculation will be based on convenience sample considering previous studies and the size of our population in Hemodialysis.
Distribution will be assessed with the Shapiro-Wilks test.
The difference between continuous variables will be evaluated with one-way ANOVA test.
The difference between nominal variables will be evaluated with the Chi-square test.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/04/2016
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Date of last participant enrolment
Anticipated
10/06/2016
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Actual
15/12/2016
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Date of last data collection
Anticipated
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Actual
2/03/2017
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Sample size
Target
30
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Accrual to date
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Final
33
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Recruitment outside Australia
Country [1]
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Mexico
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State/province [1]
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Nuevo Leon
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Unidad de Hemodialisis del Hospital Universitario “Dr. Jose Eleuterio Gonzalez” de la Universidad Autonoma de Nuevo Leon
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Address [1]
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Av. Francisco I. Madero s/n, Col. Mitras Centro, C. P. 64460. Monterrey, Nuevo Leon, Mexico.
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Country [1]
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Mexico
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Primary sponsor type
Hospital
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Name
Unidad de Hemodialisis del Hospital Universitario “Dr. Jose Eleuterio Gonzalez” de la Universidad Autonoma de Nuevo Leon
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Address
Av. Francisco I. Madero s/n, Col. Mitras Centro, C. P. 64460. Monterrey, Nuevo Leon, Mexico.
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Country
Mexico
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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UANL Faculty of Medicine Ethics Committee
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Ethics committee address [1]
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Av. Francisco I. Madero s/n, Col. Mitras Centro, C. P. 64460. Monterrey, Nuevo Leon, Mexico.
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Ethics committee country [1]
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Mexico
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Date submitted for ethics approval [1]
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14/09/2014
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Approval date [1]
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13/11/2014
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Ethics approval number [1]
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MI14-008
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Summary
Brief summary
Intradialytic hypotension (IH) is common complication in patients with stage 5 chronic kidney disease (CKD5) on hemodialysis. Its incidence ranges from 15 to 30%. Levocarnitine (LC) has been used as a part of treatment in these kind of patients. LC is a quaternary amine involved in intermediary energetic metabolism, and is also essential in transferring long chain fatty acids through mitochondrial membranes. Those with CKD have relative deficiency of LC. A single-center, prospective, randomized, placebo-controlled quadruple-blinded trial was designed to demonstrate the efficiency of LC in the prevention of IH in patients with CKD5. The subjects will be chosen by convenience sampling. They will be further divided into 4 groups (group 1 [gLC0]: LC [30 mg/kg] at 0 min before starting hemodialysis session; group 2 [gLC30]: LC [30 mg/kg] at 30 min before starting the hemodialysis session; group 3[gP0]: normal saline [5 mL/kg] at 0 min before starting hemodialysis session; group 4 [gP30]: normal saline [5 mL/kg] at 30 min before starting hemodialysis session). The intervention will last 12 weeks.
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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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Dr Hector Raul Ibarra-Sifuentes
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Address
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Internal Medicine, Faculty of Medicine, UANL, Av. Francisco I. Madero s/n, Col. Mitras Centro, C. P. 64460. Monterrey, Nuevo Leon, Mexico.
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Country
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Mexico
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Phone
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+528183488928
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Fax
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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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Hector Raul Ibarra-Sifuentes
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Address
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Internal Medicine, Faculty of Medicine, UANL, Av. Francisco I. Madero s/n, Col. Mitras Centro, C. P. 64460. Monterrey, Nuevo Leon, Mexico.
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Country
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Mexico
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Phone
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+528183488928
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Fax
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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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Hector Raul Ibarra-Sifuentes
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Address
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Internal Medicine, Faculty of Medicine, UANL, Av. Francisco I. Madero s/n, Col. Mitras Centro, C. P. 64460. Monterrey, Nuevo Leon, Mexico.
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Country
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Mexico
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Phone
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+528183488928
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Fax
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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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