Targeting Peroxisome Proliferator-activated Receptor-gamma in Peritoneal Dialysis Patients - Will it Reduce Inflammation, Atherosclerosis, Calcification and Improve Survival of Peritoneal Dialysis Patients?

Hospital Authority, Hong Kong

Status

Unknown

Conditions

Chronic Disease

Kidney Diseases

Cardiovascular Diseases

Treatments

Drug: rosiglitazone

Study type

Interventional

Funder types

Other

Identifiers

NCT00516880

HARECCTR0500007

UW05-236T/899

Details and patient eligibility

About

Peritoneal dialysis patients are at increased risk of cardiovascular morbidity and mortality and are related to the presence of accelerated atherosclerosis. Our recent data showed that inflammation predicts mortality and cardiovascular death, independent of other cardiovascular risk factors in peritoneal dialysis patients. As a considerable proportion of peritoneal dialysis patients showed evidence of inflammation, it raises an important question as to whether anti-inflammatory treatment has any cardiovascular and survival benefit in these patients. The peroxisome proliferator-activated receptor-gamma (PPAR-g) agonist is a class of drug with insulin sensitizing property. Recent experimental and clinical studies demonstrated that this class of drug has anti-inflammatory and anti-atherosclerotic properties other than insulin sensitizing effect in type 2 diabetics. We therefore hypothesize that modulation of the PPAR-g activity may be a novel therapeutic strategy for reducing inflammation and retarding the progression of atherosclerosis and possibly lowering mortality in our peritoneal dialysis patients.

Enrollment

160 estimated patients

Sex

All

Ages

20 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Both prevalent patients or patients newly started on continuous ambulatory peritoneal dialysis with age between 20 - 75 with or without diabetes mellitus will be considered eligible for study entry. For patients newly started on continuous ambulatory peritoneal dialysis, they will be suitable for recruitment into the study after one month on continuous ambulatory peritoneal dialysis.

Exclusion criteria

Patients with underlying malignancy
Patients with chronic liver disease or liver cirrhosis
Patients with hepatitis B or C positive
Patients with active infections
Patients with other chronic active inflammatory disease such as systemic lupus erythematosus, rheumatoid arthritis
Patients who refuse study participation
Patients with underlying congenital heart disease or rheumatic heart disease
Patients with poor general condition
Patients with plans for living related kidney transplant within 2 years
Female patients with pregnancy
Patients with history of recurrent hypoglycemia
Patients with Class III and IV congestive heart failure
Patients already receiving glitazones treatment at the screening visit