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Trial registered on ANZCTR
Registration number
ACTRN12611000035921
Ethics application status
Approved
Date submitted
3/01/2011
Date registered
11/01/2011
Date last updated
15/04/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Drugs and kidney function in the older age group
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Scientific title
Drug handling in the older age group: The impact of renal tubular function
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Secondary ID [1]
253336
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Analysis of renal tubular function with respect to drug handling in individuals aged >65 years ?
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Condition category
Condition code
Renal and Urogenital
259016
259016
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0
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Kidney disease
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
A simple one off administration of a drug cocktail (fluconazole 50mg single oral dose, pindolol 15mg single oral dose, para-aminohippurate 440 mg iv over 1 minute ) given simultaneously to measure tubular secretion and reabsorption is both safe and representative of tubular function. GFR will be measured using standard radioisotope (chromium) labelled EDTA clearance. Using these methods, we will compare a normal (normal plasma creatinine, no known medical conditions) older age group (aged >65) with a matched aged group with mild renal impairment (eGFR < 60 ml/min) as well as a younger normal group (20 -40 yrs). A more accurate estimate of the contribution of renal tubular function for drug handling will allow safer drug prescribing especially in the elderly patients. Participants will be recruited over a 6 month period.
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Intervention code [1]
257788
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Not applicable
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Comparator / control treatment
we will compare a normal (normal plasma creatinine, no known medical conditions) older age group (aged >65) with a matched aged group with mild renal impairment (eGFR < 60 ml/min) as well as a younger normal group (20 -40 yrs).
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Control group
Active
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Outcomes
Primary outcome [1]
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In clinical practice it is assumed that changes in tubular function parallel changes in GFR. However this may be incorrect.
As most drugs are organic acids, renal tubular handling may play a critical role in the elimination of drugs.
Clearance of these drugs will be determined by analysis of area under receiver operated curves (ROC) and correlated to the GFR clearances.
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Assessment method [1]
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Timepoint [1]
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Blood samples wlll be collected at time 0, and 1hr,2hr,4hr,6hr, 24hr post drug administration and timed urine samples (0-3hr, 3-6hr, 6-24hr) will be collected for each participant. The samples will be stored and analysed as a single batch at the completion of the study.
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
268747
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nil
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Eligibility
Key inclusion criteria
Group 1. Normal individuals aged > 65 years with a normal plasma creatinine and calculated creatinine clearance > 60 ml/min.
Group 2. Individuals aged > 65 years with evidence of mild renal impairment (Stage 3 CKD GFR 35 -60ml/min).
Group 3. A younger normal cohort aged 30 – 50 for comparison with group 1.
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Minimum age
65
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria. Not able to give consent.
Impaired renal function < than 35 ml/min.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/02/2011
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Actual
5/04/2011
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Date of last participant enrolment
Anticipated
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Actual
24/05/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3115
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New Zealand
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State/province [1]
3115
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Otago
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Funding & Sponsors
Funding source category [1]
258259
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Charities/Societies/Foundations
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Name [1]
258259
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Otago Medical Research Foundation
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Address [1]
258259
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C/o University of Otago
PO Box 56
Dunedin 9054
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Country [1]
258259
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
C/o University of Otago
PO Box 56
Dunedin 9054
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
257424
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Address [1]
257424
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Country [1]
257424
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
260234
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Northern Y Regional Ethics Committee
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Ethics committee address [1]
260234
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3rd floor, BNZ building 354 Victoria St PO Box 1031 Hamilton 3240
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Ethics committee country [1]
260234
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New Zealand
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Date submitted for ethics approval [1]
260234
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Approval date [1]
260234
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24/12/2010
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Ethics approval number [1]
260234
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NTY/10/12/2103
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Summary
Brief summary
The kidney plays a major role in the handling of most drugs by several mechanisms including filtration and tubular secretion / reabsorption. With renal impairment, modification of drug doses is required. In clinical practise, changes in renal function are estimated according to the creatinine clearance (CrCl) (estimate of glomerular filtration rate [GFR]). The formulae used, include age as a variable that assumes that renal function declines with age alone. It is also assumed that changes in tubular function parallel changes in GFR , but this may not be correct. Given that many drugs are organic acids, tubular secretion / reabsorption are important variables that in the setting of impaired kidney function may significantly alter drug handling. Previous studies have shown that a simple drug cocktail given simultaneously to measure tubular secretion and reabsorption is both safe and representative of tubular function in younger subjects. Using this method, we will compare a normal (normal plasma creatinine, no known medical conditions) older age group (aged >65) with a matched aged group with mild renal impairment (eGFR < 60 ml/min) as well as a younger normal group (20 -40 yrs). A more accurate estimate of the contribution of renal tubular function for drug handling will allow safer drug prescribing especially in the elderly patients.
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Trial website
Nil
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Trial related presentations / publications
Nil
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Public notes
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Contacts
Principal investigator
Name
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Prof Robert Walker
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Address
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Department of Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
NZ
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Country
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New Zealand
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Phone
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6434740999
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Fax
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6434747641
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Email
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[email protected]
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Contact person for public queries
Name
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Prof Robert Walker
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Address
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Department of Medicine
Dunedin School of Medicine
University of Otago
PO Box 913
Dunedin. 9054
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Country
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New Zealand
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Phone
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+64 3 4740999 Ex 8045
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Fax
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+ 64 3 474 7641
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Email
15293
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[email protected]
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Contact person for scientific queries
Name
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Prof Robert Walker
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Address
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Department of Medicine
Dunedin School of Medicine
University of Otago
PO Box 913
Dunedin. 9054
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Country
6221
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New Zealand
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Phone
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+64 3 4740999 Ex 8045
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Fax
6221
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+ 64 3 474 7641
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A Population Pharmacokinetic Model for 51Cr EDTA to Estimate Renal Function.
2017
https://dx.doi.org/10.1007/s40262-016-0489-x
N.B. These documents automatically identified may not have been verified by the study sponsor.
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