Malnutrition, Diet and Racial Disparities in Chronic Kidney Disease (CKD)

NCT01415570 | Unknown

• 2 other identifiers: 14100K24DK091419
• Study Type: observational
• Target: 1,050
• Locations: 1 country
• Sites: 1

Brief Summary

In the United States, African Americans are 3.6 time and Hispanics 1.5 times more likely to suffer from chronic kidney disease and need dialysis treatment for life, when compared to the non-Hispanic Whites. Unfortunately many dialysis patients die, so that after 5 years only less than 35% are still alive. Dialysis patients who appear malnourished or who have muscle and fat wasting are even more likely to die. Interestingly, among dialysis patients, minorities (African Americans, Hispanics and Asian Americans) usually survive longer than the non-Hispanic Whites. If the investigators can discover the reasons for these so-called "racial survival disparities" of dialysis patients, the investigators may be able to improve survival for all dialysis patients and maybe even for many other people who suffer from other chronic diseases. During this 5 year study the investigators would like to test if a different nutrition and diet can explain better survival of minority dialysis patients. The investigators will also test if in additional to nutrition there are 2 other reasons for better survival of minority dialysis patients, namely differences in bone and minerals and differences in social and psychological and mental health. The investigators plan to study 450 hemodialysis patients every 6 months in several dialysis clinics in Los Angeles South Bay area. These subjects will include 30% African Americans, 30% Hispanics, 30% non-Hispanic Whites and 10% Asians. Every 6 months the investigators will examine their nutritional conditions, dietary intake, psycho-social conditions and quality of life, and will recruit 75 new subjects to replace those who left our study as a result of kidney transplantation, death or other reasons. Hence, the investigators estimate studying a total of 1,050 hemodialysis patients over 5 years. Clinical events such as hospital admissions and survival will be followed. Blood samples will be obtained every 6 months for measurements of hormones and "biomarkers", and the remainder of the blood will be stored in freezers for future measurements. The investigators plan to design and develop race and ethnicity specific nutritional risk scores and food questionnaires and will test some of these scores in larger national databases of hemodialysis patients. Almost a year after the study starts, the investigators also plan to do additional tests of body composition and dietary intake in a smaller group of these patients at the GCRC.

Conditions

Chronic Kidney Disease (CKD); End-Stage Renal Disease (ESRD)

Keywords

Protein-energy wasting (PEW); racial disparities; hemodialysis; survival paradoxes; Stage 5

Outcome Measures

Primary Outcomes (1)

• All-cause mortality

  5-years (60 months)

Secondary Outcomes (1)

• Quality of life

  5 years

Study Arms (2)

Chronic Hemodialysis Patients

Adult hemodialysis patients

Chronic hemodialysis patients

Adult hemodialysis patients

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Adult (18-85 yrs) patients, hemodialysis (HD) \> 4 weeks

You may qualify if:

• Adult (18-85 yrs) patients
• HD \> 4 weeks

You may not qualify if:

• Terminal disease with life expectancy \< 6 months

Sponsors & Collaborators

• Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center: lead
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): collaborator
• Davita Clinical Research: collaborator

Study Sites (1)

Harold Simmons Center for Kidney Disease Research & Epidemiology

Torrance, California, 90502, United States

RECRUITING

Related Publications (10)

• Noori N, Kovesdy CP, Dukkipati R, Feroze U, Molnar MZ, Bross R, Nissenson AR, Kopple JD, Norris KC, Kalantar-Zadeh K. Racial and ethnic differences in mortality of hemodialysis patients: role of dietary and nutritional status and inflammation. Am J Nephrol. 2011;33(2):157-67. doi: 10.1159/000323972. Epub 2011 Feb 4.

  PMID: 21293117 BACKGROUND

• Feroze U, Noori N, Kovesdy CP, Molnar MZ, Martin DJ, Reina-Patton A, Benner D, Bross R, Norris KC, Kopple JD, Kalantar-Zadeh K. Quality-of-life and mortality in hemodialysis patients: roles of race and nutritional status. Clin J Am Soc Nephrol. 2011 May;6(5):1100-11. doi: 10.2215/CJN.07690910. Epub 2011 Apr 28.

  PMID: 21527646 BACKGROUND

• Kalantar-Zadeh K, Kovesdy CP, Bross R, Benner D, Noori N, Murali SB, Block T, Norris J, Kopple JD, Block G. Design and development of a dialysis food frequency questionnaire. J Ren Nutr. 2011 May;21(3):257-62. doi: 10.1053/j.jrn.2010.05.013. Epub 2010 Sep 15.

  PMID: 20833073 BACKGROUND

• Bross R, Noori N, Kovesdy CP, Murali SB, Benner D, Block G, Kopple JD, Kalantar-Zadeh K. Dietary assessment of individuals with chronic kidney disease. Semin Dial. 2010 Jul-Aug;23(4):359-64. doi: 10.1111/j.1525-139X.2010.00743.x. Epub 2010 Jul 29.

  PMID: 20673254 BACKGROUND

• Bross R, Chandramohan G, Kovesdy CP, Oreopoulos A, Noori N, Golden S, Benner D, Kopple JD, Kalantar-Zadeh K. Comparing body composition assessment tests in long-term hemodialysis patients. Am J Kidney Dis. 2010 May;55(5):885-96. doi: 10.1053/j.ajkd.2009.12.031. Epub 2010 Mar 25.

  PMID: 20346558 BACKGROUND

• Kalantar-Zadeh K, Kovesdy CP, Derose SF, Horwich TB, Fonarow GC. Racial and survival paradoxes in chronic kidney disease. Nat Clin Pract Nephrol. 2007 Sep;3(9):493-506. doi: 10.1038/ncpneph0570.

  PMID: 17717562 BACKGROUND

• Kalantar-Zadeh K, Golan E, Shohat T, Streja E, Norris KC, Kopple JD. Survival disparities within American and Israeli dialysis populations: learning from similarities and distinctions across race and ethnicity. Semin Dial. 2010 Nov-Dec;23(6):586-94. doi: 10.1111/j.1525-139X.2010.00795.x.

  PMID: 21175833 BACKGROUND

• Streja E, Kovesdy CP, Molnar MZ, Norris KC, Greenland S, Nissenson AR, Kopple JD, Kalantar-Zadeh K. Role of nutritional status and inflammation in higher survival of African American and Hispanic hemodialysis patients. Am J Kidney Dis. 2011 Jun;57(6):883-93. doi: 10.1053/j.ajkd.2010.10.050. Epub 2011 Jan 15.

  PMID: 21239093 BACKGROUND

• Molnar MZ, Streja E, Kovesdy CP, Budoff MJ, Nissenson AR, Krishnan M, Anker SD, Norris KC, Fonarow GC, Kalantar-Zadeh K. High platelet count as a link between renal cachexia and cardiovascular mortality in end-stage renal disease patients. Am J Clin Nutr. 2011 Sep;94(3):945-54. doi: 10.3945/ajcn.111.014639. Epub 2011 Aug 3.

  PMID: 21813809 BACKGROUND

• Rhee CM, You AS, Nguyen DV, Brunelli SM, Budoff MJ, Streja E, Nakata T, Kovesdy CP, Brent GA, Kalantar-Zadeh K. Thyroid Status and Mortality in a Prospective Hemodialysis Cohort. J Clin Endocrinol Metab. 2017 May 1;102(5):1568-1577. doi: 10.1210/jc.2016-3616.

  PMID: 28324018 DERIVED

Biospecimen

Retention: SAMPLES WITH DNA

Blood samples

MeSH Terms

Conditions

Renal Insufficiency, Chronic; Kidney Failure, Chronic

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Kamyar Kalantar-Zadeh, MD, MPH, PhD

  LABioMed at Harbor-UCLA

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Caludia Luna

CONTACT

310-222-2346; cluna@labiomed.org

Jennie Jing, MS

CONTACT

310-781-3650; jjing@labiomed.org

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 10, 2011
• First Posted: August 12, 2011
• Study Start: August 1, 2011
• Primary Completion: August 1, 2016
• Study Completion: November 1, 2016
• Last Updated: May 21, 2015

Record last verified: 2015-05

Locations

US (1)