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Effect of an L-carnitine-containing Peritoneal Dialysis (PD) Solution on Insulin Sensitivity in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD)

Primary Purpose

End Stage Renal Disease, Insulin Resistance

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
PD solution containing glucose
PD solution containing glucose and L-carnitine
Sponsored by
Iperboreal Pharma Srl
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for End Stage Renal Disease focused on measuring Peritoneal dialysis, L-carnitine, Insulin resistance, Glucose homeostasis, Dyslipidemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years
  2. Have a diagnosis of ESRD and have been on Continuous Ambulatory Peritoneal Dialysis (CAPD) for at least 3 months
  3. Be in a stable clinical condition during the four weeks immediately prior to Screening Period as demonstrated by medical history, physical examination and laboratory testing
  4. Have a blood hemoglobin concentration above 8,5 g/100ml (data will be verified with Investigators)
  5. Have not experienced peritonitis episodes in the last 3 months
  6. Be treated with Extraneal (nocturnal exchange bag solution) for at least 1 month
  7. Be treated with 3 diurnal exchange bag solutions (1.5% or 2.5% glucose) and one nocturnal exchange bag solution (Extraneal)
  8. Have Kt/V urea measurement > 1.7 per week in a previous test performed within 6 months that should be confirmed at Baseline Visit
  9. Have a minimum weekly creatinine clearance of 45 litres in a previous test performed within 6 months that should be confirmed at Baseline Visit
  10. Have a D/P Creatinine ratio at Peritoneal Equilibration Test (PET) between 0.50 and 0.81 in a previous test performed within 6 months that should be confirmed at Baseline Visit
  11. Have a D/P Glucose ratio at Peritoneal Equilibration Test (PET) between 0.26 and 0.49 in a previous test performed within 6 months that should be confirmed at Baseline Visit
  12. Be treated by the participating clinical Investigator for a period of at least three months
  13. Have understood and signed the Informed Consent Form.

Exclusion Criteria:

  1. Have a history of drug or alcohol abuse in the six months prior to entering the protocol
  2. Be in treatment with androgens
  3. Have Diabetes Mellitus (as defined by the American Diabetes Society, objectively documented by a fasting plasma glucose and HbA1c determinations)
  4. Have clinically significant abnormal liver function test (SGOT, SGPT, and gamma-GT > 2 times the upper normal limit)
  5. Have acute infectious conditions (i.e.: pulmonary infection, acute hepatitis, high or low urinary tract infections, renal parenchymal infection, pericarditis, etc)
  6. Have a history of congestive heart failure and clinically significant arrhythmia
  7. Have an history of epilepsy or any NCS disease
  8. Have malignancy within the past 5 years, including lymphoproliferative disorders
  9. Have any medical condition that, in the judgment of the Investigator, would jeopardize the patient's safety following exposure to study drug, particularly if patient's life expectancy is less than 1 year
  10. Have a history of L-Carnitine therapy or use in the month prior to entering the protocol
  11. Have used any investigational drug in the 3 months prior to entering the protocol
  12. Be in pregnancy, lactation, fertility age without protection against pregnancy by adequate contraceptive means

Sites / Locations

  • Renal and Dialysis, Bari Policlinic Hospital
  • Renal, Dialysis and Transplant Unit, University of Bari
  • Division of Nephrology, University of "G. d'Annunzio"
  • Nephrologyand Dialysis Unit, Desio Hospital
  • Nephrology and Dialysis Unit, "Maria SS dello Splendore" Hospital
  • Nephrology and Dialysis Unit, "Renzetti" Hospital
  • Division of Nephrology and Dialysis, Ospedale Policlinico Maggiore
  • Nephrology and Dialysis Unit, "G. Bernabeo" Hospital
  • Renal Unit, Policlinico MultiMedica
  • Nephrology and Dialysis Unit, "SS Annunziata" Hospital
  • Division of Nephrology and Dialysis, "Mazzini" Hospital
  • Nephrology and Dialysis Unit, "San Pio da Pietrelcina" Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Glucose solution

Glucose and L-carnitine solution

Arm Description

Outcomes

Primary Outcome Measures

To assess the efficacy of L-Carnitine containing PD solution on insulin sensitivity evaluated by euglycemic hyperinsulinemic clamp

Secondary Outcome Measures

To assess the efficacy of L-Carnitine containing PD solution on plasma lipids and lipoprotein profile
To assess the efficacy of L-Carnitine containing PD solution on hematological parameters (hemoglobin and EPO requirements)

Full Information

First Posted
September 18, 2008
Last Updated
June 24, 2019
Sponsor
Iperboreal Pharma Srl
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1. Study Identification

Unique Protocol Identification Number
NCT00755456
Brief Title
Effect of an L-carnitine-containing Peritoneal Dialysis (PD) Solution on Insulin Sensitivity in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD)
Official Title
Phase 2 Study of the Effect of a Peritoneal Dialysis Solution Containing Glucose (1.5%) and L-carnitine (0.1%) on Insulin Sensitivity in Patients on Continuous Ambulatory Peritoneal Dialysis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
January 2008 (Actual)
Primary Completion Date
September 2012 (Actual)
Study Completion Date
October 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Iperboreal Pharma Srl

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The current study is initiated in order to assess the impact of a PD solution containing L-carnitine on insulin sensitivity measured by a hyperinsulinemic euglycemic clamp.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End Stage Renal Disease, Insulin Resistance
Keywords
Peritoneal dialysis, L-carnitine, Insulin resistance, Glucose homeostasis, Dyslipidemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
35 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Glucose solution
Arm Type
Active Comparator
Arm Title
Glucose and L-carnitine solution
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
PD solution containing glucose
Other Intervention Name(s)
Dianeal (Baxter)
Intervention Description
Instillation of PD solutions containing Glucose (1.5 or 2.5%, w/v) for the diurnal exchanges, and 1 PD solution containing icodextrin (7.5 w/v) for nocturnal exchange. PD solutions are instilled for 120 days.
Intervention Type
Drug
Intervention Name(s)
PD solution containing glucose and L-carnitine
Intervention Description
Instillation of PD solutions containing Glucose (1.5 or 2.5%, w/v) and L-carnitine (0.1%, w/v) for the diurnal exchanges, and 1 PD solution containing icodextrin (7.5 w/v) for nocturnal exchanges. PD solutions are instilled for 120 days.
Primary Outcome Measure Information:
Title
To assess the efficacy of L-Carnitine containing PD solution on insulin sensitivity evaluated by euglycemic hyperinsulinemic clamp
Time Frame
time 0, 4 months
Secondary Outcome Measure Information:
Title
To assess the efficacy of L-Carnitine containing PD solution on plasma lipids and lipoprotein profile
Time Frame
-2 weeks, time 0, 1 month, 2 months, 3 months, 4 months
Title
To assess the efficacy of L-Carnitine containing PD solution on hematological parameters (hemoglobin and EPO requirements)
Time Frame
-2 weeks, time 0, 2 months, 4 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years Have a diagnosis of ESRD and have been on Continuous Ambulatory Peritoneal Dialysis (CAPD) for at least 3 months Be in a stable clinical condition during the four weeks immediately prior to Screening Period as demonstrated by medical history, physical examination and laboratory testing Have a blood hemoglobin concentration above 8,5 g/100ml (data will be verified with Investigators) Have not experienced peritonitis episodes in the last 3 months Be treated with Extraneal (nocturnal exchange bag solution) for at least 1 month Be treated with 3 diurnal exchange bag solutions (1.5% or 2.5% glucose) and one nocturnal exchange bag solution (Extraneal) Have Kt/V urea measurement > 1.7 per week in a previous test performed within 6 months that should be confirmed at Baseline Visit Have a minimum weekly creatinine clearance of 45 litres in a previous test performed within 6 months that should be confirmed at Baseline Visit Have a D/P Creatinine ratio at Peritoneal Equilibration Test (PET) between 0.50 and 0.81 in a previous test performed within 6 months that should be confirmed at Baseline Visit Have a D/P Glucose ratio at Peritoneal Equilibration Test (PET) between 0.26 and 0.49 in a previous test performed within 6 months that should be confirmed at Baseline Visit Be treated by the participating clinical Investigator for a period of at least three months Have understood and signed the Informed Consent Form. Exclusion Criteria: Have a history of drug or alcohol abuse in the six months prior to entering the protocol Be in treatment with androgens Have Diabetes Mellitus (as defined by the American Diabetes Society, objectively documented by a fasting plasma glucose and HbA1c determinations) Have clinically significant abnormal liver function test (SGOT, SGPT, and gamma-GT > 2 times the upper normal limit) Have acute infectious conditions (i.e.: pulmonary infection, acute hepatitis, high or low urinary tract infections, renal parenchymal infection, pericarditis, etc) Have a history of congestive heart failure and clinically significant arrhythmia Have an history of epilepsy or any NCS disease Have malignancy within the past 5 years, including lymphoproliferative disorders Have any medical condition that, in the judgment of the Investigator, would jeopardize the patient's safety following exposure to study drug, particularly if patient's life expectancy is less than 1 year Have a history of L-Carnitine therapy or use in the month prior to entering the protocol Have used any investigational drug in the 3 months prior to entering the protocol Be in pregnancy, lactation, fertility age without protection against pregnancy by adequate contraceptive means
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mario Bonomini, MD
Organizational Affiliation
G. d'Annunzio University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Arduino Arduini, MD
Organizational Affiliation
Iperboreal Pharma Srl
Official's Role
Study Director
Facility Information:
Facility Name
Renal and Dialysis, Bari Policlinic Hospital
City
Bari
ZIP/Postal Code
70124
Country
Italy
Facility Name
Renal, Dialysis and Transplant Unit, University of Bari
City
Bari
ZIP/Postal Code
70124
Country
Italy
Facility Name
Division of Nephrology, University of "G. d'Annunzio"
City
Chieti
ZIP/Postal Code
66100
Country
Italy
Facility Name
Nephrologyand Dialysis Unit, Desio Hospital
City
Desio
ZIP/Postal Code
20100
Country
Italy
Facility Name
Nephrology and Dialysis Unit, "Maria SS dello Splendore" Hospital
City
Giulianova
ZIP/Postal Code
64021
Country
Italy
Facility Name
Nephrology and Dialysis Unit, "Renzetti" Hospital
City
Lanciano
ZIP/Postal Code
66034
Country
Italy
Facility Name
Division of Nephrology and Dialysis, Ospedale Policlinico Maggiore
City
Milano
ZIP/Postal Code
20121
Country
Italy
Facility Name
Nephrology and Dialysis Unit, "G. Bernabeo" Hospital
City
Ortona
ZIP/Postal Code
66026
Country
Italy
Facility Name
Renal Unit, Policlinico MultiMedica
City
Sesto San Giovanni
ZIP/Postal Code
20099
Country
Italy
Facility Name
Nephrology and Dialysis Unit, "SS Annunziata" Hospital
City
Sulmona
ZIP/Postal Code
67039
Country
Italy
Facility Name
Division of Nephrology and Dialysis, "Mazzini" Hospital
City
Teramo
ZIP/Postal Code
64100
Country
Italy
Facility Name
Nephrology and Dialysis Unit, "San Pio da Pietrelcina" Hospital
City
Vasto
ZIP/Postal Code
66054
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
23725973
Citation
Bonomini M, Di Liberato L, Del Rosso G, Stingone A, Marinangeli G, Consoli A, Bertoli S, De Vecchi A, Bosi E, Russo R, Corciulo R, Gesualdo L, Giorgino F, Cerasoli P, Di Castelnuovo A, Monaco MP, Shockley T, Rossi C, Arduini A. Effect of an L-carnitine-containing peritoneal dialysate on insulin sensitivity in patients treated with CAPD: a 4-month, prospective, multicenter randomized trial. Am J Kidney Dis. 2013 Nov;62(5):929-38. doi: 10.1053/j.ajkd.2013.04.007. Epub 2013 May 29.
Results Reference
result

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Effect of an L-carnitine-containing Peritoneal Dialysis (PD) Solution on Insulin Sensitivity in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD)

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