Peroxisome Proliferator-Activated Receptor-gamma (PPAR-gamma) Agonist in Diabetic End-Stage Renal Disease Patients

The University of Hong Kong (HKU)

Status

Completed

Conditions

Diabetes

Endstage Renal Disease

Treatments

Drug: Placebo comparator

Drug: Pioglitazone

Study type

Interventional

Funder types

Other

Identifiers

NCT00745914

A111-103

Details and patient eligibility

About

To test the hypothesis that PPAR-gamma agonist, rosiglitazone, induces carotid plaque regression in diabetic ESRD patients on maintenance PD via its anti-inflammatory property.

Full description

End-stage renal disease (ESRD) patients are at an increased risk of accelerated atherosclerosis and cardiovascular morbidity and mortality. Non-traditional risk factors such as inflammation and insulin resistance have important contributions to accelerated atherosclerosis in ESRD patients receiving long-term peritoneal dialysis (PD). The peroxisome proliferator-activated receptor-g (PPAR-g) is a member of the nuclear receptor family of ligand-dependent transcription factors. Activation of the PPAR-g has been shown in both clinical and experimental studies to have anti-inflammatory and anti-atherosclerotic properties other than insulin-sensitizing effects. Recent study also showed that PPAR-g agonists reduce plaque inflammation by inhibiting the activation of proinflammatory genes responsible for plaque development and growth. Hence, this study aims to examine the effects of PPAR-g activation on the progression of carotid plaque in diabetic ESRD patients receiving long-term PD using high-resolution magnetic resonance imaging (MRI).

Enrollment

22 patients

Sex

All

Ages

18 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Diabetic ESRD patients receiving long-term PD treatment, with carotid plaque (defined as focal intima-media thickening >1mm) present on screening ultrasonography
Patients who provide informed consent for the study

Exclusion criteria

Patients with systemic inflammatory disease such as systemic lupus erythematosus
Patients with chronic liver disease or cirrhosis
Patients with current active malignancy
Patients with chronic rheumatic heart disease or congenital heart disease
Patients with poor general condition
Patients with plan for living related kidney transplant within coming 1 year
Patients with pre-existing class III/IV heart failure,
Patients with recurrent hypoglycemia
Patients already on glitazone treatment
Female patients with pregnancy
Patients with contraindications for MRI examination including those with pacemaker or metallic implant.