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A randomized control trial to assess the impact of vitamin D supplementation compared to placebo on vascular stiffness in chronic kidney disease patients

机译:一项评估安慰剂与安慰剂相比对慢性肾脏病患者血管硬度的影响的随机对照试验

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Background Vitamin D deficiency is associated with cardiovascular (CV) risk in multiple populations, including those with chronic kidney disease (CKD). The active form of the hormone (1,25 OH2D3) binds to receptors in multiple organs. CKD patients are deficient in both 25 Vitamin D and 1,25 OH2D3. Clinical trial data demonstrating the benefits of vitamin D formulations are limited, and fail to show significant benefits on CV outcomes, and have compared different compounds, in various populations, and focused on a variety of outcomes. A understanding of the mechanism by which different vitamin D compounds confer CV protection in CKD is important for the design of future studies. Methods/Design This 3 arm randomized prospective double-blinded placebo-controlled study examining the impact of calcitriol (1,25 OH2D3) and 25-hydroxyvitamin D3 supplementation compared to placebo on vascular stiffness, as measured by pulse wave velocity (PWV). Patients are enrolled from 2 tertiary care institutions if they meet inclusion criteria (stable estimated glomerular filtration rate (eGFR) between 15-45ml/min, Discussion This study is novel in that we are using a robust study design in CKD patients (not on dialysis) comparing placebo to different forms of vitamin D supplementation in fixed doses, irrespective of baseline values. We hope to demonstrate the biological mechanistic effect of vitamin D supplementation on vascular function in order for this information to be used in designing larger randomized controlled trials. Trial registration Current Controlled Trials NCT01247311 . Date of Registration: November 12, 2010.
机译:背景技术维生素D缺乏症与包括慢性肾脏病(CKD)在内的多个人群的心血管(CV)风险有关。激素的活性形式(1,25 OH 2 D 3)与多个器官的受体结合。 CKD患者缺乏25种维生素D和1,25 OH 2 D 3 。证明维生素D制剂益处的临床试验数据有限,并且未能显示出对CV结果的显着益处,并且未对各种人群中的不同化合物进行比较,并侧重于各种结果。了解不同维生素D化合物在CKD中赋予CV保护的机理对于未来研究的设计很重要。方法/设计这项三组随机前瞻性双盲安慰剂对照研究,比较了骨化三醇(1,25 OH 2 D 3 )和补充25-羟基维生素D3的影响用脉搏波速度(PWV)来衡量安慰剂对血管硬度的影响。如果患者符合入选标准(稳定的估计肾小球滤过率(eGFR)在15-45ml / min之间,则从两个三级医疗机构入组,讨论)本研究是新颖的,因为我们在CKD患者中使用了稳健的研究设计(非透析治疗)比较固定剂量的安慰剂和不同形式的维生素D(无论基线值如何),我们希望证明维生素D补充对血管功能的生物学机制,以便将该信息用于设计较大的随机对照试验。注册当前对照试验NCT01247311。注册日期:2010年11月12日。

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