Acute Effects of Intravenous Iron on Oxidative Stress and Endothelial Dysfunction in Non-dialysis CKD
Primary Purpose
Renal Anemia, Iron Toxicity, Oxidative Stress
Status
Active
Phase
Phase 4
Locations
Romania
Study Type
Interventional
Intervention
Sodium Chloride 0.9% Intravenous Solution
Ferinject
Sponsored by

About this trial
This is an interventional treatment trial for Renal Anemia focused on measuring CKD, anemia, iron, endothelial dysfunction, oxidative stress
Eligibility Criteria
Inclusion Criteria:
- Chronic kidney disease stages G3-G5 (defined according to KDIGO criteria);
- Anemia (defined according to KDIGO criteria) and iron deficiency defined as serum ferritin < 100 ng/mL and/or TSAT < 20% (KDIGO).
Exclusion Criteria:
- contraindications of intravenous iron therapy: iron allergy, active infection, hemochromatosis, iron overload (serum ferritin > 500 ng/mL and/or transferrin saturation > 50%);
- treatment with iron and erythropoiesis-stimulating agents (at the time of recruitment and 6 months previously);
- active smoker status;
- antioxidant food supplements treatment in the last 3 months;
- clinically manifest bleeding;
- another cause of anemia (hemoglobinopathies, vitamin B12 and/or folic acid deficiency suggested by the megaloblastic peripheral blood smears's appearance, multiple myeloma and other paraproteinemias);
- severe anemia (Hb < 7 g/dl);
- baseline FMD < 7% (the existence of atherosclerosis which limits arterial reactivity);
- cancer (currently or in the past 6 months);
- hepatopathies (increased serum transaminases ≥ 3 x normal value) or hepatic impairment ≥ grade Child B;
- autoimmune disorders or significant inflammation (as defined by C-reactive protein > 5 mg/L);
- pregnancy or lactation;
- participation in other clinical trials over the upast 3 months;
- patient unwillingness.
Sites / Locations
- "Dr. Carol Davila" Teaching Hospital of Nephrology
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
Placebo
Ferric carboxymaltose
Arm Description
Intervention: 250 mL Sodium Chloride 0.9% Intravenous Solution, representing control infusion, over 30 minutes.
Intervention: 1000 mg Ferinject in 250 mL 0.9%NaCl, representing medication in study infusion, over 30 minutes.
Outcomes
Primary Outcome Measures
Effect on endothelial function
Description of the endothelial function variation (changing in flow-mediated vasodilatation (FMD) endothelium-dependent, and also in serum sICAM-1, sVCAM-1 and nitric oxide metabolism parameters ) after administration of a single intravenous dose of iron versus a control solution, in CKD non-dialysis patients.
Oxidative stress
Description of some free radicals production's markers (lipid peroxidation and carbonyl stress assessment) and in antioxidant system in plasma markers variation after administration of a single intravenous iron dose versus a control solution, in non-dialysis CKD subjects.
Secondary Outcome Measures
Correlation between endothelial dysfunction and oxidative stress markers
Evaluation of correlations between changes in oxidative stress parameters and endothelial function after a single intravenous iron administration compared to a control solution in non-dialysis CKD subjects.
Full Information
NCT ID
NCT03388385
First Posted
December 18, 2017
Last Updated
August 14, 2022
Sponsor
Carol Davila University of Medicine and Pharmacy
Collaborators
S.C. Sanador S.R.L
1. Study Identification
Unique Protocol Identification Number
NCT03388385
Brief Title
Acute Effects of Intravenous Iron on Oxidative Stress and Endothelial Dysfunction in Non-dialysis CKD
Official Title
The Effects of a Single Intravenous Iron Upon Vascular Endothelium and Some Parameters of Oxidative Stress in Patients With Non-dialysis Chronic Kidney Disease
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 20, 2017 (Actual)
Primary Completion Date
December 30, 2020 (Actual)
Study Completion Date
December 20, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Carol Davila University of Medicine and Pharmacy
Collaborators
S.C. Sanador S.R.L
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
5. Study Description
Brief Summary
The purpose of this study is to investigate the effects of acute intravenous iron administration on the endothelial function in non-dialysis Chronic Kidney Disease stages G3-G5 patients with anemia and iron deficiency, in relation to changes in oxidative and nitrosative status.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Anemia, Iron Toxicity, Oxidative Stress, Endothelial Dysfunction
Keywords
CKD, anemia, iron, endothelial dysfunction, oxidative stress
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
40 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Intervention: 250 mL Sodium Chloride 0.9% Intravenous Solution, representing control infusion, over 30 minutes.
Arm Title
Ferric carboxymaltose
Arm Type
Active Comparator
Arm Description
Intervention: 1000 mg Ferinject in 250 mL 0.9%NaCl, representing medication in study infusion, over 30 minutes.
Intervention Type
Drug
Intervention Name(s)
Sodium Chloride 0.9% Intravenous Solution
Other Intervention Name(s)
Physiologic saline
Intervention Description
Physiologic saline infusion will be infused in day 1.
Intervention Type
Drug
Intervention Name(s)
Ferinject
Other Intervention Name(s)
Ferric carboxymaltose
Intervention Description
Ferric carboxymaltose will be infused in day 2.
Primary Outcome Measure Information:
Title
Effect on endothelial function
Description
Description of the endothelial function variation (changing in flow-mediated vasodilatation (FMD) endothelium-dependent, and also in serum sICAM-1, sVCAM-1 and nitric oxide metabolism parameters ) after administration of a single intravenous dose of iron versus a control solution, in CKD non-dialysis patients.
Time Frame
through study completion, an average of 1 year
Title
Oxidative stress
Description
Description of some free radicals production's markers (lipid peroxidation and carbonyl stress assessment) and in antioxidant system in plasma markers variation after administration of a single intravenous iron dose versus a control solution, in non-dialysis CKD subjects.
Time Frame
through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
Correlation between endothelial dysfunction and oxidative stress markers
Description
Evaluation of correlations between changes in oxidative stress parameters and endothelial function after a single intravenous iron administration compared to a control solution in non-dialysis CKD subjects.
Time Frame
through study completion, an average of 1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Chronic kidney disease stages G3-G5 (defined according to KDIGO criteria);
Anemia (defined according to KDIGO criteria) and iron deficiency defined as serum ferritin < 100 ng/mL and/or TSAT < 20% (KDIGO).
Exclusion Criteria:
contraindications of intravenous iron therapy: iron allergy, active infection, hemochromatosis, iron overload (serum ferritin > 500 ng/mL and/or transferrin saturation > 50%);
treatment with iron and erythropoiesis-stimulating agents (at the time of recruitment and 6 months previously);
active smoker status;
antioxidant food supplements treatment in the last 3 months;
clinically manifest bleeding;
another cause of anemia (hemoglobinopathies, vitamin B12 and/or folic acid deficiency suggested by the megaloblastic peripheral blood smears's appearance, multiple myeloma and other paraproteinemias);
severe anemia (Hb < 7 g/dl);
baseline FMD < 7% (the existence of atherosclerosis which limits arterial reactivity);
cancer (currently or in the past 6 months);
hepatopathies (increased serum transaminases ≥ 3 x normal value) or hepatic impairment ≥ grade Child B;
autoimmune disorders or significant inflammation (as defined by C-reactive protein > 5 mg/L);
pregnancy or lactation;
participation in other clinical trials over the upast 3 months;
patient unwillingness.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gabriel Mircescu, Professor
Organizational Affiliation
Carol Davila University of Medicine and Pharmacy
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Cristina Capusa, Assoc. Prof.
Organizational Affiliation
Carol Davila University of Medicine and Pharmacy
Official's Role
Study Director
Facility Information:
Facility Name
"Dr. Carol Davila" Teaching Hospital of Nephrology
City
Bucharest
Country
Romania
12. IPD Sharing Statement
Learn more about this trial
Acute Effects of Intravenous Iron on Oxidative Stress and Endothelial Dysfunction in Non-dialysis CKD
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