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Carbonaceous Oral Adsorbent's Effects on Progression of Chronic Kidney Disease (CAP-KD)

Primary Purpose

Kidney Failure, Chronic

Status
Completed
Phase
Phase 4
Locations
Japan
Study Type
Interventional
Intervention
Kremezin
Sponsored by
Institute for Health Outcomes and Process Evaluation Reseach
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Kidney Failure, Chronic focused on measuring chronic kidney disease, oral carbonaceous adsorbent, randomized clinical trial, composite endpoint

Eligibility Criteria

20 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subject is an outpatient.
  • The subject is 20 years of age or older at the time of consent to participate in the study.
  • The subject's serum creatinine value is 5.0 mg/dl or less at the time of case registration.
  • The inverse serum creatinine value, calculated using measurements at four or more time points during an observation period that occurs within 48 weeks of case registration, is decreasing, on average, according to linear-regression analysis performed at the case registration center.
  • The subject's blood pressure is well controlled before the initial serum creatinine measurement during the observation period.
  • The subject has been treated with an ACEI and/or ARB before the initial serum creatinine measurement during the observation period.
  • The subject has undergone low-protein diet therapy (> 0.8 g/kg per day) before the initial serum creatinine measurement during the observation period.
  • The subject has not changed the type or dose of medication for renal failure for 4 weeks prior to case registration.
  • The subject has participated in thorough consultation and has been informed as to the purpose, description, expected adverse effects, and risks of this study according to the consent form, and has voluntarily signed the informed consent form.

Exclusion Criteria:

  • The subject has a passage disorder of the gastrointestinal tract.
  • The subject has been treated with Kremezin within the period from the initial measurement of the serum creatinine level prior to case registration to the time of study commencement.
  • The subject has rapid progressive glomerular nephritis, hydronephrosis, occlusive urinary tract injury, drug-induced nephropathy, or transplanted kidney.
  • The subject has complications such as severe hepatopathy, liver cirrhosis, severe infection, class III or above New York Heart Association (NYHA) congestive heart failure, severe arrhythmia, or unstable angina.
  • The subject has had cardiac infarction, cerebral infarction, or cerebral hemorrhage within the past 6 months.
  • The subject presents with severe nephrotic syndrome (serum albumin < 2 g/dl).
  • The subject is currently pregnant, or plans to become pregnant during the study period.
  • The subject abuses alcohol.
  • The subject has a body weight less than 80% or more than 160% of the standard weight {[height(m)]^2 x 22}.
  • The subject has significant difficulty in controlling his/her blood sugar level within 3 months of case registration (hemoglobin [Hb]A1c > 8.0% on one occasion).
  • The subject has a progressive malignant tumor.
  • The subject is not available for study visits at least once per 2 months to provide urine samples.
  • The subject is inappropriate for participation in the study for other reasons, as determined by an investigator.

Sites / Locations

  • iHope International

Outcomes

Primary Outcome Measures

The composite primary endpoint comprises the following events:
Doubling of serum Creatinine
Increase in serum Creatinine to 6.0 mg/dl or more
Endstage renal disease (ESRD; defined as that requiring dialysis or renal transplantation)
Death

Secondary Outcome Measures

Variation in urinary protein
Changes in Creatinine Clearance
Changes in health-related quality of life (HRQOL)
Occurrence of adverse events

Full Information

First Posted
April 4, 2007
Last Updated
October 17, 2007
Sponsor
Institute for Health Outcomes and Process Evaluation Reseach
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1. Study Identification

Unique Protocol Identification Number
NCT00456859
Brief Title
Carbonaceous Oral Adsorbent's Effects on Progression of Chronic Kidney Disease
Acronym
CAP-KD
Official Title
Carbonaceous Oral Adsorbent's Effects on Progression of Chronic Kidney Disease (CAP-KD)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2007
Overall Recruitment Status
Completed
Study Start Date
April 2004 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
September 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Institute for Health Outcomes and Process Evaluation Reseach

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The CAP-KD trial is a prospective, multicenter, randomized, open-label, two-arm, parallel group comparison clinical trial and will be conducted as a researcher-directed study to assess the efficacy of Kremezin in preventing the progression of CKD. We compare two groups of patients: those receiving conventional treatment alone and those receiving such treatment paired with Kremezin.
Detailed Description
A clinical trial to evaluate the efficacy of the oral carbonaceous adsorbent Kremezin in preventing the progression of chronic kidney disease (the Carbonaceous Oral Adsorbent's Effects on Progression of Chronic Kidney Disease [CAP-KD] trial) in predialysis patients. In the trial we are comparing two treatments: conventional treatment comprising an ACEI and/or ARB together with a low-protein diet, and combination treatment comprising the conventional treatment paired with Kremezin. Furthermore, we will compare the QOL in both groups of patients

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Failure, Chronic
Keywords
chronic kidney disease, oral carbonaceous adsorbent, randomized clinical trial, composite endpoint

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
450 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Kremezin
Primary Outcome Measure Information:
Title
The composite primary endpoint comprises the following events:
Title
Doubling of serum Creatinine
Title
Increase in serum Creatinine to 6.0 mg/dl or more
Title
Endstage renal disease (ESRD; defined as that requiring dialysis or renal transplantation)
Title
Death
Secondary Outcome Measure Information:
Title
Variation in urinary protein
Title
Changes in Creatinine Clearance
Title
Changes in health-related quality of life (HRQOL)
Title
Occurrence of adverse events

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject is an outpatient. The subject is 20 years of age or older at the time of consent to participate in the study. The subject's serum creatinine value is 5.0 mg/dl or less at the time of case registration. The inverse serum creatinine value, calculated using measurements at four or more time points during an observation period that occurs within 48 weeks of case registration, is decreasing, on average, according to linear-regression analysis performed at the case registration center. The subject's blood pressure is well controlled before the initial serum creatinine measurement during the observation period. The subject has been treated with an ACEI and/or ARB before the initial serum creatinine measurement during the observation period. The subject has undergone low-protein diet therapy (> 0.8 g/kg per day) before the initial serum creatinine measurement during the observation period. The subject has not changed the type or dose of medication for renal failure for 4 weeks prior to case registration. The subject has participated in thorough consultation and has been informed as to the purpose, description, expected adverse effects, and risks of this study according to the consent form, and has voluntarily signed the informed consent form. Exclusion Criteria: The subject has a passage disorder of the gastrointestinal tract. The subject has been treated with Kremezin within the period from the initial measurement of the serum creatinine level prior to case registration to the time of study commencement. The subject has rapid progressive glomerular nephritis, hydronephrosis, occlusive urinary tract injury, drug-induced nephropathy, or transplanted kidney. The subject has complications such as severe hepatopathy, liver cirrhosis, severe infection, class III or above New York Heart Association (NYHA) congestive heart failure, severe arrhythmia, or unstable angina. The subject has had cardiac infarction, cerebral infarction, or cerebral hemorrhage within the past 6 months. The subject presents with severe nephrotic syndrome (serum albumin < 2 g/dl). The subject is currently pregnant, or plans to become pregnant during the study period. The subject abuses alcohol. The subject has a body weight less than 80% or more than 160% of the standard weight {[height(m)]^2 x 22}. The subject has significant difficulty in controlling his/her blood sugar level within 3 months of case registration (hemoglobin [Hb]A1c > 8.0% on one occasion). The subject has a progressive malignant tumor. The subject is not available for study visits at least once per 2 months to provide urine samples. The subject is inappropriate for participation in the study for other reasons, as determined by an investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yasushi Asano
Organizational Affiliation
Jichi Medical University
Official's Role
Study Chair
Facility Information:
Facility Name
iHope International
City
Tokyo
ZIP/Postal Code
102-0072
Country
Japan

12. IPD Sharing Statement

Citations:
PubMed Identifier
16189630
Citation
Morita S, Fukuhara S, Akizawa T, Asano Y, Kurokawa K. Study design and methods for a clinical trial of an oral carbonaceous adsorbent used to prevent the progression of chronic kidney disease (CAP-KD). Clin Exp Nephrol. 2005 Sep;9(3):219-27. doi: 10.1007/s10157-005-0358-7.
Results Reference
background
PubMed Identifier
19615804
Citation
Akizawa T, Asano Y, Morita S, Wakita T, Onishi Y, Fukuhara S, Gejyo F, Matsuo S, Yorioka N, Kurokawa K; CAP-KD Study Group. Effect of a carbonaceous oral adsorbent on the progression of CKD: a multicenter, randomized, controlled trial. Am J Kidney Dis. 2009 Sep;54(3):459-67. doi: 10.1053/j.ajkd.2009.05.011. Epub 2009 Jul 17. Erratum In: Am J Kidney Dis. 2010 Mar;55(3):616.
Results Reference
derived

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Carbonaceous Oral Adsorbent's Effects on Progression of Chronic Kidney Disease

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