search
Back to results

The Association Between Sleep Duration and Sleep Disorders and Proteinuria in Children

Primary Purpose

OSA, Proteinuria, Periodic Limb Movement Sleep Disorder

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
PSG
Sponsored by
Tel-Aviv Sourasky Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for OSA focused on measuring osa, proteinuria, periodic limb movement disorder, children

Eligibility Criteria

2 Years - 17 Years (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. age: 2-17 years
  2. Referred to overnight PSG due to suspected OSA or PLMD
  3. referred for evaluation in the nephrology clinic due to proteinuria

Exclusion Criteria:

  1. Known renal disease;
  2. diabetes mellitus;
  3. current use of ACE inhibitors or angiotensin receptor blockers;
  4. neuromuscular disorders
  5. craniofacial abnormalities
  6. syndromic conditions.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    children referred to PSG due to suspected SDB

    Arm Description

    Outcomes

    Primary Outcome Measures

    morning urine protein/creatinine >0.2
    reported sleep duration (hours)
    morning urine protein/creatinine >0.2 post treatment of OSA

    Secondary Outcome Measures

    Full Information

    First Posted
    April 14, 2019
    Last Updated
    April 28, 2019
    Sponsor
    Tel-Aviv Sourasky Medical Center
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT03933046
    Brief Title
    The Association Between Sleep Duration and Sleep Disorders and Proteinuria in Children
    Official Title
    The Association Between Sleep Duration and Sleep Disorders and Proteinuria in Children
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2019
    Overall Recruitment Status
    Unknown status
    Study Start Date
    May 1, 2019 (Anticipated)
    Primary Completion Date
    May 1, 2021 (Anticipated)
    Study Completion Date
    September 1, 2021 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Tel-Aviv Sourasky Medical Center

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The presence of protein in urine is a common laboratory finding in children. Although proteinuria is usually benign, it can be a marker of a serious underlying renal disease or systemic disorder. Microalbuminuria can be one of the first subclinical manifestations of endothelial dysfunction and is associated with low grade systemic inflammation. Multiple studies from the adult population suggest that microalbuminuria above the upper quartile is linked with increased risk of coronary heart disease and death even after adjustment for the presence of diabetes mellitus, obesity and hypertension. Obstructive sleep apnea (OSA) has been recognized as an independent risk factor for cardiovascular morbidity related to sympathetic nervous system overflow, metabolic dysregulation, inflammation and endothelial dysfunction secondary to repetitive hypoxia -reoxygenation events. Therefore, there is a need for further studies to investigate the association between OSA and microalbuminuria in children. Furthermore, no studies have thus far investigated the association between other sleep disorders such as periodic limb movement (PLMD) and microalbuminuria in children. Our hypothesis is that children with sleep disorders or short sleep duration have increased risk of proteinuria/microalbuminuria and that treatment and resolution of the sleep problem will be followed by improvement in proteinuria levels.
    Detailed Description
    200 children aged 2-18 years that will be referred to the Sleep Disorders Center for overnight polysomnography due to suspected sleep disordered breathing or PLMD will be recruited to the study during their first visit in the sleep clinic. During that study, an informed consent will be completed by the parents. Data on weekdays and weekends sleep duration as well as personal and family history of kidney disease will be collected. Exclusion criteria:1. Known renal disease; 2. diabetes mellitus; 3. current use of ACE inhibitors or angiotensin receptor blockers; 4. neuromuscular disorders or craniofacial abnormalities; 5. syndromic conditions. All participants will undergo physical examination. Weight and height will be measured, and body mass index (BMI) z-score will be calculated. Blood pressure will be measured on the first visit in the sleep clinic by a trained physician as specified in recent guidelines. 19 Overnight polysomnography will be carried out in the Sleep Disorders Laboratory and the following signals will be recorded: electroencephalogram (EEG; C3/M2, C2/M1, O1/M2, O2/M1); right and left oculogram; submental and tibial electromyogram; body position; electrocardiogram; thoracic and abdominal wall motion; oronasal airflow (three-pronged thermistor and nasal pressure transducer); and oxygen saturation of hemoglobin (SpO2). Arousals, sleep stages and respiratory events will be scored, and polysomnography indices will be defined according to the recent American Academy of Sleep Medicine recommendations . 20 First void urine samples will be collected in a sterile cup the morning following the polysomnography (6:00-7:00 am). For each sample urinalysis, protein/creatinine and albumin/creatinine will be measured. Urinary albumin and protein excretion will be the primary outcome measure. Proteinuria will be defined as protein/creatinine greater than 0.2 and albuminuria will be defined as albumin/creatinine above age-adjusted limits Children who will be diagnosed with moderate-severe OSA will be referred to an ENT surgeon for adenotonsillectomy, the first line of treatment in pediatric OSA. Six to 10 weeks following surgery, these children will be requested to undergo additional PSG evaluation. First void urine samples will be collected the following morning. In addition- 100 children referred to the pediatric nephrology clinic due to asymptomatic albuminuria/proteinuria will be recruited. Parents will be required to complete a designated sleep questionnaire that includes items on sleep duration, SDB and RLS symptoms. Exclusion criteria, as described above for the entire cohort, will also apply to this subpopulation. Informed consent will be completed by the parents.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    OSA, Proteinuria, Periodic Limb Movement Sleep Disorder
    Keywords
    osa, proteinuria, periodic limb movement disorder, children

    7. Study Design

    Primary Purpose
    Screening
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    300 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    children referred to PSG due to suspected SDB
    Arm Type
    Experimental
    Intervention Type
    Diagnostic Test
    Intervention Name(s)
    PSG
    Other Intervention Name(s)
    urine analysis
    Intervention Description
    polysomnography and urine analaysis for protein levels
    Primary Outcome Measure Information:
    Title
    morning urine protein/creatinine >0.2
    Time Frame
    1 year
    Title
    reported sleep duration (hours)
    Time Frame
    1 year
    Title
    morning urine protein/creatinine >0.2 post treatment of OSA
    Time Frame
    1 year

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    2 Years
    Maximum Age & Unit of Time
    17 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: age: 2-17 years Referred to overnight PSG due to suspected OSA or PLMD referred for evaluation in the nephrology clinic due to proteinuria Exclusion Criteria: Known renal disease; diabetes mellitus; current use of ACE inhibitors or angiotensin receptor blockers; neuromuscular disorders craniofacial abnormalities syndromic conditions.

    12. IPD Sharing Statement

    Learn more about this trial

    The Association Between Sleep Duration and Sleep Disorders and Proteinuria in Children

    We'll reach out to this number within 24 hrs