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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03020303
Registration number
NCT03020303
Ethics application status
Date submitted
11/01/2017
Date registered
13/01/2017
Titles & IDs
Public title
Aldosterone bloCkade for Health Improvement EValuation in End-stage Renal Disease
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Scientific title
Aldosterone bloCkade for Health Improvement EValuation in End-stage Renal Disease
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Secondary ID [1]
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ACHIEVE
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Universal Trial Number (UTN)
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Trial acronym
ACHIEVE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Endstage Renal Disease
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Spironolactone 25Mg Tablet
Treatment: Drugs - Placebo Oral Tablet
Placebo comparator: Placebo Oral Tablet - A tablet with no active medication that will be an exact match of the active spironolactone in taste and appearance
Active comparator: Spironolactone 25 MG Tablet - 25 mg of active spironolactone in tablet form
Treatment: Drugs: Spironolactone 25Mg Tablet
Randomized participants will receive a study supply of spironolactone 25 mg tablets. They will be instructed to take 1 tablet daily.
Treatment: Drugs: Placebo Oral Tablet
Randomized participants will receive a study supply of placebo tablets with no active medical ingredients. They will be instructed to take 1 tablet daily.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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CV Death or Hospitalization for Heart Failure
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Assessment method [1]
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Timepoint [1]
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up to 5 years
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Secondary outcome [1]
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Cause specific death
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Assessment method [1]
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Timepoint [1]
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up to 5 years
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Secondary outcome [2]
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Hospitalization for Heart Failure
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Assessment method [2]
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Timepoint [2]
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up to 5 years
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Secondary outcome [3]
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All-cause death
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Assessment method [3]
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Timepoint [3]
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up to 5 years
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Secondary outcome [4]
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All-cause Hospitalization
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Assessment method [4]
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Timepoint [4]
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up to 5 years
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Secondary outcome [5]
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Hospitalization for hyperkalemia
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Assessment method [5]
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Timepoint [5]
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up to 5 years
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Eligibility
Key inclusion criteria
1. Age
1. =45 years or
2. =18 with a history of diabetes
2. On dialysis = 90 days
3. On either
1. Hemodialysis prescribed at least 2 treatments per week or
2. Peritoneal dialysis prescribed with at least 1 exchange daily
4. Provides informed consent
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Minimum age
18
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Maximum age
No limit
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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. Hyperkalemia
1. Serum potassium >5.8 mmol/L in the 6 weeks prior to enrollment or
2. Serum potassium >6.0 mmol/L during active run-in
2. Currently taking and unable to withdraw a mineralocorticoid receptor antagonist (i.e. spironolactone or eplerenone).
3. Known sensitivity or allergy to spironolactone
4. Current or planned pregnancy or breastfeeding
5. Scheduled living related donor renal transplant
6. Life expectancy < 6 months in the opinion of a treating nephrologist.
7. Enrolled in another interventional trial testing a mineralocorticoid receptor antagonist or drug that has a known or likely interaction with spironolactone.
8. Treating physician believes either spironolactone is either absolutely indicated or absolutely contra-indicated
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 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
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
7/07/2017
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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
1/01/2025
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Actual
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Sample size
Target
2750
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,QLD,VIC
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Recruitment hospital [1]
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Canberra Hospital - Garran
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Concord Repatriation General Hospital - Concord
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Northern Beaches Hospital - Frenchs Forest
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Royal North Shore Hospital - Wahroonga
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Sydney Adventist Hospital - Wahroonga
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Sunshine Coast University Hospital - Birtinya
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Royal Brisbane Women's Hospital - Herston
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Princess Alexandra Hospital - Woolloongabba
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Monash Health - Clayton
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Western Health - Sunshine Hospital - Saint Albans
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2605 - Garran
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2139 - Concord
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2086 - Frenchs Forest
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2076 - Wahroonga
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4575 - Birtinya
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4029 - Herston
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4102 - Woolloongabba
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Recruitment postcode(s) [8]
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3168 - Clayton
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Recruitment postcode(s) [9]
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3021 - Saint Albans
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Recruitment outside Australia
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Brazil
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Bahia
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Brazil
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Montevideo
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Funding & Sponsors
Primary sponsor type
Other
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Name
Population Health Research Institute
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Address
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Other collaborator category [1]
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Name [1]
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Canadian Institutes of Health Research (CIHR)
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Ethics approval
Ethics application status
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Summary
Brief summary
Individuals receiving dialysis are at risk of heart failure and heart related death. There is an urgent need for treatments that reduce the risk of these problems in patients that require dialysis. Spironolactone is a pill used to prevent heart failure and related deaths in patients that do not require dialysis. It works by blocking a hormone (aldosterone) in your body that causes high blood pressure and can damage the heart. Although spironolactone is very effective in patients that do not require dialysis, we do not know if spironolactone is effective in dialysis patients. Our research will help determine if spironolactone reduces heart failure and heart related deaths in dialysis patients. The purpose of this study is to determine if spironolactone reduces death or hospitalization for heart failure and is well tolerated in patients that require dialysis.
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Trial website
https://clinicaltrials.gov/study/NCT03020303
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Trial related presentations / publications
Quach K, Lvtvyn L, Baigent C, Bueti J, Garg AX, Hawley C, Haynes R, Manns B, Perkovic V, Rabbat CG, Wald R, Walsh M. The Safety and Efficacy of Mineralocorticoid Receptor Antagonists in Patients Who Require Dialysis: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2016 Oct;68(4):591-598. doi: 10.1053/j.ajkd.2016.04.011. Epub 2016 Jun 3. Walsh M, Manns B, Garg AX, Bueti J, Rabbat C, Smyth A, Tyrwhitt J, Bosch J, Gao P, Devereaux PJ, Wald R. The Safety of Eplerenone in Hemodialysis Patients: A Noninferiority Randomized Controlled Trial. Clin J Am Soc Nephrol. 2015 Sep 4;10(9):1602-8. doi: 10.2215/CJN.12371214. Epub 2015 Jul 2. Soomro QH, Charytan DM. Mineralocorticoid Receptor Antagonists and Cardiovascular Health with Kidney Failure. Clin J Am Soc Nephrol. 2021 Jun;16(6):843-845. doi: 10.2215/CJN.04460421. No abstract available. Collister D, Mbuagbaw L, Guyatt G, Devereaux PJ, Tennankore KK, Reis G, Sola L, Xavier D, Jha V, Gallagher M, Dans AL, Liu W, de Zoysa J, Felix C, Mark PB, Li Z, Tyrwhitt J, Wilkinson J, Sheridan P, Yuan F, Walsh M; ACHIEVE investigators. Three week compared to seven week run-in period length and the assessment of pre-randomization adherence: A study within a trial. Contemp Clin Trials. 2021 Aug;107:106466. doi: 10.1016/j.cct.2021.106466. Epub 2021 Jun 5. Hasegawa T, Nishiwaki H, Ota E, Levack WM, Noma H. Aldosterone antagonists for people with chronic kidney disease requiring dialysis. Cochrane Database Syst Rev. 2021 Feb 15;2(2):CD013109. doi: 10.1002/14651858.CD013109.pub2.
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Public notes
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Contacts
Principal investigator
Name
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Michael Walsh, MD, PhD
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Address
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McMaster University
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Email
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Contact person for public queries
Name
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Jessica Tyrwhitt, B.A.
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Address
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Phone
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9055274322
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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
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
N/A - no plan to make IPD available to other researchers
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03020303