End-Stage Kidney Disease
Conditions
Keywords
ER stress, Peritoneal Dialysis
Brief summary
Peritoneal fibrosis is one of the major causes of technical failure in patients on peritoneal dialysis (PD) for long period of time. Although the exact mechanisms of peritoneal damage during PD still remain unclear, generation of Endoplasmic reticulum (ER) stress may be responsible for progressive membrane dysfunction. Ursodeoxycholic acid (URSA) is a powerful inhibitor of ER stress to protect peritoneal fibrosis in peritoneal dialysis in the investigators in-vitro study. In this study the researchers investigated the hypothesis that URSA protect peritoneal membrane damage.
Detailed description
Ursodeoxycholic acid (URSA) is known to be relatively safe and beneficial in peritoneal dialysis patient at a dose of 300 mg per day. Patients will be randomly assigned to URSA and placebo group and prescribed according to the protocol. At 2 and 6 month, Peritoneal equilibrium test (PET) will be performed with blood sampling.
Interventions
Inhibition of ER stress (Ursodeoxycholic Acid)
Sponsors
Study design
Eligibility
Inclusion criteria
* Maintenance peritoneal dialysis at least 3 months * Patients who are able and willing to understand, sign and date an informed consent document, and authorize access to protected health information
Exclusion criteria
* Episode of peritonitis at least 3 months * Episodes of admission due to other disease at lease 3 months * Liver disease * Allergic history with Ursodeoxycholic acid * Nausea or vomiting after Ursodeoxycholic acid
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peritoneal membrane function | 6 months | Changes in peritoneal membrane function (Δ D/Pcreatinine, ΔD/Purea) with peritoneal equilibrium test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Residula renal function | 6 months | Changes in estimated GFR |
| Epithelial to Mesenchymal Transition, EMT | 6 months | Phenotypic changes of Mesothelial cells |
| Oxydative stress | 6 months | Measurement of GSH/GSSG, 8-OHdG |