Nicotinamide Riboside Supplementation in Chronic Kidney Disease

NCT07693543 | Not Yet Recruiting Phase 2 DMC

• 2 other identifiers: UCSD-NR-0011K01DK147652
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This study is testing whether a dietary supplement called nicotinamide riboside, (NR), can be used in adults with moderate chronic kidney disease. NR is a form of vitamin B3 that may help support cellular energy metabolism. The main goal of this study is to see whether it is feasible for people with chronic kidney disease to take NR daily, complete study visits, and follow the study procedures. The study will also explore whether NR chloride affects markers of mitochondrial health, small blood vessel function, and physical function. Participants will be randomly assigned to one of two treatment orders. One group will take NR first and placebo second. The other group will take placebo first and NR second. Placebo looks like NR but does not contain active NR. Each treatment period lasts 12 weeks, with an approximately 2-week washout period between treatments. Neither participants nor the study team will know which treatment participants are taking during each period. Study visits will include blood and urine collection, physical function testing, and noninvasive tests of small blood vessel function. The study will enroll up to 36 adults with moderate chronic kidney disease at the University of California, San Diego.

Conditions

Chronic Kidney Disease

Keywords

Nicotinamide riboside; Chronic kidney disease; Microvascular function; Physical function; Cell-free mitochondrial DNA

Outcome Measures

Primary Outcomes (2)

• Change in plasma cell-free mitochondrial DNA

  Change in plasma cell-free mitochondrial DNA concentration, measured as mitochondrial DNA copies per mL of plasma using droplet digital PCR.

  Baseline, Week 12, and Week 26

• Change in urine cell-free mitochondrial DNA

  Change in urine cell-free mitochondrial DNA concentration, measured using droplet digital PCR and reported as mitochondrial DNA copies normalized to urine osmolarity.

  Baseline, Week 12, and Week 26

Secondary Outcomes (6)

• Change in skin fingernail capillary density

  Baseline, Week 12, and Week 26

• Change in skin blood flow

  Baseline, Week 12, and Week 26

• Change in six-minute walk distance

  Baseline, Week 12, and Week 26

• Change in Handgrip Strength

  Baseline, Week 12, and Week 26

• Change in Timed Up and Go

  Baseline, Week 12, and Week 26

Study Arms (2)

Placebo Then NR

EXPERIMENTAL

Participants assigned to this arm will receive matched placebo for 12 weeks, followed by an approximately 14-day washout/crossover period, then nicotinamide riboside 1000 mg/day for 12 weeks.

Dietary Supplement: Matched Placebo (Capsules)

NR Then Placebo

EXPERIMENTAL

Participants assigned to this arm will receive nicotinamide riboside 1000 mg/day for 12 weeks, followed by an approximately 14-day washout/crossover period, then matched placebo for 12 weeks.

Dietary Supplement: Nicotinamide Riboside (NR)

Interventions

Nicotinamide Riboside (NR) DIETARY_SUPPLEMENT

Nicotinamide riboside will be administered orally at a target dose of 1000 mg/day for 12 weeks during the active treatment period.

NR Then Placebo

Matched Placebo (Capsules) DIETARY_SUPPLEMENT

Matched placebo will be administered orally for 12 weeks during the placebo treatment period. The placebo will be identical or substantially similar in appearance to the active nicotinamide riboside study product to maintain blinding.

Placebo Then NR

Eligibility Criteria

• Age: 30 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Moderate chronic kidney disease not treated with dialysis, defined as eGFR 30-59 mL/min/1.73 m2 using the CKD-EPI equation.
• Urine albumin-to-creatinine ratio (uACR) \<300 mg/g.
• Able to provide informed consent.
• Able to walk unassisted from room to room, with usual assistive device allowed if approved by study safety assessment.
• Willing and able to comply with study procedures, visits, and study product administration.

You may not qualify if:

• Pregnancy.
• Expectation to start dialysis within 6 months.
• Unable to walk unassisted from room to room.
• Institutionalization or inability to consent.
• End-stage liver disease with cirrhosis.
• HIV.
• Oxygen-dependent COPD.
• Baseline systolic blood pressure \>170 mmHg or diastolic blood pressure \>100 mmHg.
• Current participation in another interventional trial.
• Use of immunosuppressive medications, including steroids or calcineurin inhibitors.
• Malignancy requiring active treatment or currently under surveillance at the discretion of the investigator.
• Hospitalization for myocardial infarction, unstable angina, cerebrovascular accident, or unstable cardiac chest pain within the prior 3 months.

Sponsors & Collaborators

• University of California, San Diego: lead

Study Sites (1)

Altman Clinical and Translation Research Institute

San Diego, California, 92093, United States

Location

Related Publications (3)

• Trammell SA, Schmidt MS, Weidemann BJ, Redpath P, Jaksch F, Dellinger RW, Li Z, Abel ED, Migaud ME, Brenner C. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nat Commun. 2016 Oct 10;7:12948. doi: 10.1038/ncomms12948.

  PMID: 27721479 BACKGROUND

• Martens CR, Denman BA, Mazzo MR, Armstrong ML, Reisdorph N, McQueen MB, Chonchol M, Seals DR. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018 Mar 29;9(1):1286. doi: 10.1038/s41467-018-03421-7.

  PMID: 29599478 BACKGROUND

• Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults. Sci Rep. 2019 Jul 5;9(1):9772. doi: 10.1038/s41598-019-46120-z.

  PMID: 31278280 BACKGROUND

MeSH Terms

Conditions

Renal Insufficiency, Chronic

Interventions

nicotinamide-beta-riboside; Capsules

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

Intervention Hierarchy (Ancestors)

Dosage Forms; Pharmaceutical Preparations

Study Officials

• Armin Ahmadi, PhD

  University of California, San Diego

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Armin Ahmadi, PhD

CONTACT

619-543-6248; a3ahmadi@ucsd.edu

Rakesh Malhotra, MD, MPH

CONTACT

r3malhotra@health.ucsd.edu

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Participants will be randomized 1:1 to one of two blinded crossover sequences: NR followed by placebo, or placebo followed by NR. Each treatment period will last 12 weeks, separated by an approximately 14-day washout/crossover period.

Study Record Dates

• First Submitted: June 29, 2026
• First Posted: July 9, 2026
• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): September 30, 2028
• Study Completion (Estimated): September 30, 2028
• Last Updated: July 15, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)