Left ventricular hypertrophy (LVH) in patients with non-dialysis dependent chronic kidney disease (CKD stage 3b and 4) Circulatory System
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients aged 18 - 75 years with CKD stage 3b-4 2. Documented 25 hydroxy vitamin D defeciency/insufficiency with serum 25 (OH)D levels between 12.5 to 75 nmol/L 3. Left ventricular mass index (LVMI) between 80 - 160 g/m2 for females and 100 - 160 g/m2 for males 4. Patients on angiotensin converting enzyme inhibitors and/or angiotensin II receptor blockers
Exclusion criteria
Exclusion criteria: 1. Presence of diabetes mellitus (type I and II) 2. Serum calcium greater than 2.55 mmol/L 3. Anaemia (Hb less than 10.0 g/dL or taking regular erythropoiesis stimulating agents) 4. Known malignancy 5. History of congestive cardiac failure or ejection fraction less than 40% on ECHO and/or plasma NT-proBNP greater than 500 pg/ml 6. Uncontrolled hypertension (blood pressure [BP] greater than 150/90 mmHg despite anti-hypertensive medication) 7. Significant valvular heart disease identified on transthoracic ECHO 8 Conditions that may influence collagen metabolism such as recent (less than 6 months) surgery or trauma, fibrotic diseases or active inflammatory conditions 9. Immunosuppressive medications 10. Presence of arterio-venous fistula for dialysis access 11. History of previous myocardial infarction (Trop T greater than 0.5)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. 10g improvement in left ventricular mass (LVM) with oral vitamin D therapy over 1 year 2. Difference in LVM in patients treated with vitamin D compared to controls Measured at 52 weeks from enrolment. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Reduction in cardiac fibrosis determined by biomarkers of cardiac fibrosis in serum post vitamin D3 therapy 2. Augmentation of adaptive immune response to Hepatitis B vaccination post oral vitamin D3 supplementation 3. Immune regulation with predominantly antiinflammatory response with oral vitamin D3 therapy 4. Measured at 52 weeks from enrolment. | — |
Countries
United Kingdom