An observational study in Arterial Calcification, Kidney Diseases and Coronary Artery Disease, sponsored by Central Jutland Regional Hospital. Completed at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-03-31.
Sponsored by Central Jutland Regional Hospital · Observational
Aim and background:
This study will seek to identify physiological and biochemical factors explaining and predicting a higher than expected central (aortic) blood pressure (BP) in patients with chronic kidney disease (CKD). The basic hypothesis of the study is that the degree of aortic calcification is an important component of elevated central BP, which, in turn, is important for the organ-damage and increased risk of cardiovascular disease associated with CKD.
Methods:
Adult patients with varying degrees of CKD undergoing scheduled coronary angiography (CAG) at Aarhus University Hospital will be included in this study.
During the CAG procedure, systolic and diastolic BP is determined in the ascending part of aorta by a calibrated pressure transducer connected to the fluid-filled CAG catheter.
Simultaneous with the registration of invasive aortic BP, estimation of central BP is performed using radial artery tonometry (SphygmoCor®), while a corresponding brachial BP is also measured.
Prior to the CAG, a non-contrast CT scan of aorta in its entirety will be performed to enable blinded quantification of calcification in the wall of aorta and coronary arteries.
Furthermore, echocardiography, resting BP measurement and a range of blood- and urine samples will be performed.
969 studies on the registry are indexed under Kidney Diseases; 183 are open to participants now.
This study's enrollment of 185 is below the median of 245 across 277 observational studies indexed under Kidney Diseases.
Browse Kidney Diseases studies →Central Jutland Regional Hospital is the lead sponsor of 32 studies on the registry; 5 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients scheduled for CAG can be included in the study if they satisfy all inclusion criteria and do not meet any exclusion criteria.
The study cohort will consist of:
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².
Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
GFR and eGFR (kidney filtering)
GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².
Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients with renal function considered normal for age (eGFR \>60 ml/min/1.73 m2) without proteinuria or structural kidney disease.
Patients with CKD stage 3a (eGFR 45-59 ml/min/1,73 m2)
Patients with CKD stage 3b (eGFR 30-44 ml/min/1,73 m2)
Patients with CKD stage 4 (eGFR 15-29 ml/min/1,73 m2)
Patients with CKD stage 5 (eGFR \<15 ml/min/1,73 m2). 50% of these patients will be in dialysis, while the other 50% will be pre-dialysis patients.
The difference between directly measured and estimated aortic (central) systolic blood pressure and the corresponding brachial systolic blood pressure
Systolic arterial pressure will be determined in the ascending part of aorta using a calibrated pressure transducer connected to the CAG catheter. Simultaneous measurement with af Oscillometric BP-device (Microlife A2 Basic) will be conducted. The difference in mmHg will be calculated.
Time frame: During the CAG-procedure
The degree of aortic calcification
The degree of calcification in the wall of the ascending, arcus, descending and abdominal aorta will be measured with a non-contrast CT scan. Agatston-scoring will be applied on the CT images 2 cm after the aortic valve to the aortic bifurcation to ensure that aortic valve calcification is not included in the score. All Agatston scoring will be performed by a radiologist blinded to information on patient biochemical characteristics.
Time frame: CT-scan will be performed prior to CAG if logistically possible and no later than 3 weeks after CAG. All Agatston scoring will be completed when all patients have been included in the study during the summer of 2021.
The difference between directly measured and estimated aortic (central) diastolic blood pressure and the corresponding brachial diastolic blood pressure.
Diastolic arterial pressure will be determined in the ascending part of aorta using a calibrated pressure transducer connected to the CAG catheter. Simultaneous measurement with af Oscillometric BP-device (Microlife A2 Basic) will be conducted. The difference in mmHg will be calculated.
Time frame: During the CAG procedure
Association between Matrix Gla Protein (MGP) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD, MGP, a novel biochemical marker of arterial calcification, will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between Calcification propensity score (T50test) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD Calcification propensity score (T50test) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between sRANKL (soluble receptor activator of nuclear factor kappa-B ligand) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD sRANKL (soluble receptor activator of nuclear factor kappa-B ligand) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between 25-OH-Vitamin D(D3+D2) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD 25-OH-Vitamin D(D3+D2) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between Fetuin-A(alfa-2-Heremans Schmid glycoprotein; AHSG) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD Fetuin-A(alfa-2-Heremans Schmid glycoprotein; AHSG) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021.
Association between Sclerostin and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD, Sclerostin will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between osteoprotegerin and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD, osteoprotegerin will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between BsAP (bone-specific alkaline phosphatase) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD, BsAP (bone-specific alkaline phosphatase) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between TRAP5B (tartrate-resistant acid phosphatase 5b) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD, TRAP5B (tartrate-resistant acid phosphatase 5b) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between P1NP (procollagen type 1 N propeptide) and aortic calcification
To establish a deeper understanding of the pathogenesis of central arterial calcification in CKD, P1NP (procollagen type 1 N propeptide) will be collected and analysed in all patients.
Time frame: Analysis will be performed as batch-analysis at the end of inclusion of patients summer 2021
Association between aortic calcification and Left Ventricular Global Longitudinal Strain (GLS) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and LVDd (Left ventricular diameter in diastole) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and IVS (Interventricular septum thickness) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Two-dimensional automated evaluation of ejection fraction (2-D auto-EF) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Aorta (sinus) diameter as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Early mitral inflow velocity (E) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Duration of Pulmonal Vein Reversal as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Late mitral inflow velocity (A) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Early diastolic mitral annulus velocity (E') as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and PW (Posterior wall thickness) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Aorta (ascendens) diameter as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and RVDd (Right ventricular diameter in diastole) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and LAD (Left atrial diameter) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and LAV (Left atrial volume) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and TEI-Index as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association between aortic calcification and Tricuspid annular plane systolic excursion (TAPSE) as determined during echocardiography.
All patients included in this study will undergo echocardiography. In particular systolic and diastolic function will be in focus. As scans will be supervised and reanalysed by a cardiologist blinded to patient CKD-stage.
Time frame: No later than 1 month after central BP measurements
Association of arterial stiffness (defined as Pulse Wave Velocity (PWV)) and aortic calcification
To get a non-invasive estimate of arterial stiffness, measurement of Pulse Wave Velocity (PWV) (carotid-femoral and carotid-radial) will be performed. PWV will be recorded with the Sphygmocor® device according to regular protocol. Calibration of the device will be performed using an oscillometric device after 5 minutes of rest. Only measurements with an estimated standard deviation of +/- 1.0 m/s will be accepted and included in the study. If possible, two acceptable measurements will be conducted for each included patient. Calculation of PWV will be performed automatically by the device using a previously published formula.
Time frame: No later than 1 month after Central BP.
Ran from Oct 2019 to primary completion in Jan 2022, 26 months.
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Central Jutland Regional Hospital