NCT03236350

Brief Summary

Chronic kidney disease (CKD) is one of the leading causes of death and disability in Singapore and worldwide. Hypertension is commonly inadequately controlled in patients with CKD and this is associated with CKD progression and cardiovascular complications. Daily episodes of Remote ischaemic conditioning (termed chronic RIC or CRIC) using transient limb ischaemia/reperfusion applied for 1 to 12 months have been shown to lower systemic blood pressure (SBP), prevent stroke and reduce post-myocardial infarction left ventricular (LV) remodelling in experimental and clinical studies. In the ERIC-BP-CKD feasibility and efficacy study, we hypothesise that CRIC administered for 28 days will lower systemic blood pressure and improve blood pressure control in patients with CKD and hypertension.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
85

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Nov 2017

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 25, 2017

Completed
7 days until next milestone

First Posted

Study publicly available on registry

August 1, 2017

Completed
4 months until next milestone

Study Start

First participant enrolled

November 28, 2017

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2020

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2020

Completed
Last Updated

September 23, 2019

Status Verified

September 1, 2019

Enrollment Period

2.3 years

First QC Date

July 25, 2017

Last Update Submit

September 19, 2019

Conditions

Keywords

Chronic Kidney DiseaseHypertensionCardiovascular DiseaseCentral Aortic Systolic PressureProteinuriaRemote Ischemic ConditioningLeft Ventricular Hypertrophy

Outcome Measures

Primary Outcomes (1)

  • Systolic blood pressure

    Difference in change in systolic blood pressure (measured by automated office blood pressure recording) from baseline to after 28 days between CRIC versus sham control therapy.

    Baseline and 28 days

Secondary Outcomes (8)

  • Number of antihypertensive medications

    Baseline and 28 days

  • Central aortic systolic pressure

    Baseline and 28 days

  • Arterial pulse waveform

    Baseline and 28 days

  • LV systolic and diastolic function

    Baseline and 28 days

  • LV wall thickness

    Baseline and 28 days

  • +3 more secondary outcomes

Study Arms (2)

CRIC Treatment

EXPERIMENTAL

An autoRIC® Device will be placed on the upper arm daily to complete the preset protocol and will be repeated daily for 28 days.

Device: Active autoRIC® (CRIC Treatment)

Sham Control

SHAM COMPARATOR

An autoRIC® Device visually identical to that used in the CRIC protocol will be placed on the upper arm daily to complete the preset protocol and will be repeated daily for 28 days.

Device: Sham Control autoRIC® (Sham Control)

Interventions

The active autoRIC® Device is programmed to go through a preset protocol of inflation and deflation cycles every session. The sessions will be repeated daily for 28 days.

CRIC Treatment

The Sham Control autoRIC® Device is visually identical to the active autoRIC® Device but the simulated protocol applied comprises of vibrations of the device but no inflation of the cuff every session. The sham device provides the same sound and vibration as that of the pump inflating and the same LED indicators on the Active Unit. The sessions will be repeated daily for 28 days.

Sham Control

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Signed informed consent
  • Aged 21 years and older
  • CKD (all stages 1-4)
  • On treatment for hypertension and automated office BP (AOBP) ≥ 140mmHg (this will be determined by an automated oscillometric BP device)

You may not qualify if:

  • Patients with polycystic kidney disease
  • Atrial fibrillation
  • Patients on long-acting sulphonylureas (eg glibenclamide) or nicorandil (as these medications may interfere with the protective effect of CRIC).
  • Patients recruited into another study which may impact on this study.
  • Symptomatic peripheral arterial disease affecting the upper limbs (given nature of upper-limb CRIC protocol).
  • Renal transplant / Dialysis patients
  • Pregnant patients
  • Patients on any anti-coagulant medications (e.g. Warfarin)
  • For echo sub-study only: Prior myocardial infarction, BMI \> 30kg/m2, known severe acrdiac valve disease, known severely impaired LVEF \<35%

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Singapore General Hospital

Singapore, 169608, Singapore

RECRUITING

Related Publications (2)

  • Hausenloy DJ, Yellon DM. Remote ischaemic preconditioning: underlying mechanisms and clinical application. Cardiovasc Res. 2008 Aug 1;79(3):377-86. doi: 10.1093/cvr/cvn114. Epub 2008 May 2.

  • Luca MC, Liuni A, McLaughlin K, Gori T, Parker JD. Daily ischemic preconditioning provides sustained protection from ischemia-reperfusion induced endothelial dysfunction: a human study. J Am Heart Assoc. 2013 Feb 22;2(1):e000075. doi: 10.1161/JAHA.112.000075.

MeSH Terms

Conditions

Renal Insufficiency, ChronicHypertensionCardiovascular DiseasesProteinuriaHypertrophy, Left Ventricular

Condition Hierarchy (Ancestors)

Renal InsufficiencyKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsVascular DiseasesUrination DisordersUrological ManifestationsSigns and SymptomsCardiomegalyHeart DiseasesHypertrophyPathological Conditions, Anatomical

Study Officials

  • Jason Choo, MBBS

    Singapore General Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 25, 2017

First Posted

August 1, 2017

Study Start

November 28, 2017

Primary Completion

March 31, 2020

Study Completion

June 30, 2020

Last Updated

September 23, 2019

Record last verified: 2019-09

Data Sharing

IPD Sharing
Will not share

Locations