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The Interplay Between Oxalate, Immunity and Infection

Primary Purpose

Kidney Stone

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Low Oxalate Diet
High Oxalate Diet
Sponsored by
University of Alabama at Birmingham
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Kidney Stone focused on measuring Oxalate

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Able to provide informed consent
  • Body Mass Index (BMI) between 20-30 kg/m2
  • Non tobacco users or not pregnant/breast feeding/nursing
  • Normal fasting blood comprehensive metabolic panel, complete blood count, C-reactive protein, and urinalysis. Must accurately collect two 24-hour urine collections within 20% of appropriate ratio of creatinine (mg)/body weight (kg) for gender
  • Healthy subjects: No history of calcium oxalate kidney stones (CaOx KS) or other medical conditions
  • Patients with CaOx KS: Recent stone composition greater than 50% CaOx; no uric acid or struvite stone content must be present. Must be first time or recurrent CaOx stone former (last stone event within the past 3 years)
  • Willing to not consume supplements (i.e. vitamins, Ca (citrate or carbonate) and other minerals, herbal supplements, nutritional aids, and probiotics) for 2 weeks before the study and during the study
  • Willing to abstain from vigorous exercise during the study as this may compromise immune function.
  • Willing to consume diets provided only by the University of Alabama Center for Clinical and Translational Science Bionutrition Core. No food allergies or intolerance to any of the foods on the study menus.
  • Willing to accurately collect 24-hour urine samples, and to have blood drawn throughout the study.
  • If on medications for kidney stone prevention (e.g. thiazides, citrate supplementation excluding calcium citrate), patients must be on a stable dose regimen for at least 8 weeks prior to and during screening, with no changes in dosing anticipated during the study. Patients should not take allopurinol for 2 weeks prior to screening since allopurinol has anti-oxidant properties.

Exclusion Criteria:

  • Failure to meet the inclusion criteria or physician refusal
  • Inability to sign and read the informed consent
  • Any medical, psychiatric, or social conditions that would prohibit participants from abiding to the study requirements
  • BMI greater than 30 kg/m2 or less than 20 kg/m2
  • Tobacco users or pregnant or breast feeding/nursing women
  • Abnormal fasting blood comprehensive metabolic panel, complete blood count, C-reactive protein, and urinalysis. Inaccurate 24-hour urine collections.
  • Healthy subjects: Taking medications or dietary supplements. History of kidney stones or any medical condition that could influence absorption or excretion of oxalate.
  • Active illness including COVID-19, flu, common cold, fever, diarrhea, urinary tract infections or other infections 14 days before the study and throughout the study.
  • Active disease including diabetes, gout, hypertension, primary hyperoxaluria, nephrotic syndrome, enteric hyperoxaluria, renal tubular acidosis, primary hyperparathyroidism, liver disease, autoimmune disorder, neurogenic bladder, urinary diversion, and bariatric surgery.
  • Active malignancy or treatment for malignancy within 12 months prior to screening.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Low Oxalate Diet Followed by High Oxalate Diet

    High Oxalate Diet Followed by Low Oxalate Diet

    Arm Description

    Subjects will consume a low oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a high oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.

    Subjects will consume a high oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a low oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.

    Outcomes

    Primary Outcome Measures

    Urinary Oxalate
    Twenty-four hour urinary oxalate will be reported as mg/day
    Crystalluria
    Twenty-four hour crystalluria will be reported as particles/ml
    Monocyte Cellular Bioenergetics
    Cellular bioenergetics will be reported as oxygen consumption rate
    Monocyte Mitochondrial Complex Activity
    Monocyte mitochondrial complex activity will be reported as oxygen consumption rate
    Monocyte Transcriptomics
    Monocyte transcriptomics will be reported as gene expression (mRNA levels)

    Secondary Outcome Measures

    Full Information

    First Posted
    October 12, 2020
    Last Updated
    May 24, 2023
    Sponsor
    University of Alabama at Birmingham
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04605055
    Brief Title
    The Interplay Between Oxalate, Immunity and Infection
    Official Title
    The Interplay Between Oxalate, Immunity and Infection
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 1, 2023 (Anticipated)
    Primary Completion Date
    November 30, 2026 (Anticipated)
    Study Completion Date
    December 31, 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of Alabama at Birmingham

    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
    This study consists of having subjects, those with calcium oxalate kidney stones as well as healthy controls, consume low and oxalate enriched diets to investigate the role of oxalate on crystalluria (the presence of crystals in urine), immunity and infection.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Kidney Stone
    Keywords
    Oxalate

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Not Applicable
    Interventional Study Model
    Crossover Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    88 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Low Oxalate Diet Followed by High Oxalate Diet
    Arm Type
    Experimental
    Arm Description
    Subjects will consume a low oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a high oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.
    Arm Title
    High Oxalate Diet Followed by Low Oxalate Diet
    Arm Type
    Experimental
    Arm Description
    Subjects will consume a high oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a low oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Low Oxalate Diet
    Intervention Description
    Participants will consume a diet that is controlled in its daily contents of oxalate and calcium, and in its content of carbohydrate, fat, and protein.
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    High Oxalate Diet
    Intervention Description
    Participants will consume a diet that is controlled in its daily contents of oxalate and calcium, and in its content of carbohydrate, fat, and protein.
    Primary Outcome Measure Information:
    Title
    Urinary Oxalate
    Description
    Twenty-four hour urinary oxalate will be reported as mg/day
    Time Frame
    Change between Baseline and Diets at 4 days
    Title
    Crystalluria
    Description
    Twenty-four hour crystalluria will be reported as particles/ml
    Time Frame
    Change between Baseline and Diets at 4 days
    Title
    Monocyte Cellular Bioenergetics
    Description
    Cellular bioenergetics will be reported as oxygen consumption rate
    Time Frame
    Change between Baseline and Diets at 4 days
    Title
    Monocyte Mitochondrial Complex Activity
    Description
    Monocyte mitochondrial complex activity will be reported as oxygen consumption rate
    Time Frame
    Change between Baseline and Diets at 4 days
    Title
    Monocyte Transcriptomics
    Description
    Monocyte transcriptomics will be reported as gene expression (mRNA levels)
    Time Frame
    Change between Baseline and Diets at 4 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Able to provide informed consent Body Mass Index (BMI) between 20-30 kg/m2 Non tobacco users or not pregnant/breast feeding/nursing Normal fasting blood comprehensive metabolic panel, complete blood count, C-reactive protein, and urinalysis. Must accurately collect two 24-hour urine collections within 20% of appropriate ratio of creatinine (mg)/body weight (kg) for gender Healthy subjects: No history of calcium oxalate kidney stones (CaOx KS) or other medical conditions Patients with CaOx KS: Recent stone composition greater than 50% CaOx; no uric acid or struvite stone content must be present. Must be first time or recurrent CaOx stone former (last stone event within the past 3 years) Willing to not consume supplements (i.e. vitamins, Ca (citrate or carbonate) and other minerals, herbal supplements, nutritional aids, and probiotics) for 2 weeks before the study and during the study Willing to abstain from vigorous exercise during the study as this may compromise immune function. Willing to consume diets provided only by the University of Alabama Center for Clinical and Translational Science Bionutrition Core. No food allergies or intolerance to any of the foods on the study menus. Willing to accurately collect 24-hour urine samples, and to have blood drawn throughout the study. If on medications for kidney stone prevention (e.g. thiazides, citrate supplementation excluding calcium citrate), patients must be on a stable dose regimen for at least 8 weeks prior to and during screening, with no changes in dosing anticipated during the study. Patients should not take allopurinol for 2 weeks prior to screening since allopurinol has anti-oxidant properties. Exclusion Criteria: Failure to meet the inclusion criteria or physician refusal Inability to sign and read the informed consent Any medical, psychiatric, or social conditions that would prohibit participants from abiding to the study requirements BMI greater than 30 kg/m2 or less than 20 kg/m2 Tobacco users or pregnant or breast feeding/nursing women Abnormal fasting blood comprehensive metabolic panel, complete blood count, C-reactive protein, and urinalysis. Inaccurate 24-hour urine collections. Healthy subjects: Taking medications or dietary supplements. History of kidney stones or any medical condition that could influence absorption or excretion of oxalate. Active illness including COVID-19, flu, common cold, fever, diarrhea, urinary tract infections or other infections 14 days before the study and throughout the study. Active disease including diabetes, gout, hypertension, primary hyperoxaluria, nephrotic syndrome, enteric hyperoxaluria, renal tubular acidosis, primary hyperparathyroidism, liver disease, autoimmune disorder, neurogenic bladder, urinary diversion, and bariatric surgery. Active malignancy or treatment for malignancy within 12 months prior to screening.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Tanecia Mitchell, PhD
    Phone
    205-996-2292
    Email
    taneciamitchell@uabmc.edu
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Tanecia Mitchell, PhD
    Organizational Affiliation
    University of Alabama at Birmingham
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

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    The Interplay Between Oxalate, Immunity and Infection

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