NCT04014127

Coronary Microvascular Dysfunction in Chronic Kidney Disease

Coronary Microvascular Dysfunction in Chronic Kidney Disease: The Chronic Renal Impairment in Birmingham Coronary Flow Reserve (CRIB FLOW) Study

• Status: Unknown
• Phase: —
• Study type: Observational
• Enrollment: 100 (estimated)
• Sponsor: University Hospital Birmingham NHS Foundation Trust · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Accepted

Summary

This is an observational study assessing coronary microvascular function in healthy controls with normal kidney function, living kidney donors, pre-dialysis patients with chronic kidney disease stage 5 and patients on peritoneal dialysis.

Detailed description

The clinical syndrome of uraemic cardiomyopathy is prevalent in end stage renal disease and is associated with pathological cardiovascular changes including left ventricular hypertrophy, diastolic dysfunction and diffuse interstitial fibrosis. These combine to confer an elevated cardiovascular risk, including an increased risk of sudden cardiac death. The cause of this increased cardiovascular risk is not clear but it is thought that coronary microvascular dysfunction may play a role. Coronary microvascular dysfunction is prevalent in many myocardial disease states, such as hypertrophic cardiomyopathy and heart failure with preserved ejection fraction, that share pathological similarities with uraemic cardiomyopathy. Coronary flow reserve, a marker of coronary microvascular function, can be assessed non-invasively using echocardiography techniques. Previous studies have shown a reduction in coronary flow reserve in patients with chronic kidney disease. However, it is not clear if kidney donors - individuals who have a reduced kidney function but do not have progressive kidney disease - also demonstrate microvascular dysfunction. Similarly, although there is some evidence that patients on dialysis have improved coronary flow reserve compared to patients with pre-dialysis chronic kidney disease stage 5, there has been limited investigation into the role of peritoneal dialysis on coronary flow reserve.

Conditions

• Kidney Disease, Chronic
• Myocardial Dysfunction

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	Coronary flow reserve assessment	Coronary flow reserve will be assessed using Doppler transthoracic echocardiograpy and myocardial contrast echocardiography.
DIAGNOSTIC_TEST	Sphygmocor	Pulse wave analysis and pulse wave velocity will be assessed using the Sphygmocor device
DIAGNOSTIC_TEST	Electrocardiogram	An electrocardiogram will be performed prior to administration of adenosine to ensure no resting conduction disease
OTHER	Blood test	Blood tests will be performed for markers of renal function, bone mineral metabolism and myocardial stretch and injury
OTHER	Urinary albumin/creatinine ratio	Urine will be analysed for albumin/creatinine ratio

Timeline

• Start date: 2019-05-07
• Primary completion: 2020-08-31
• Completion: 2020-12-31
• First posted: 2019-07-10
• Last updated: 2019-07-10

Locations

1 site across 1 country: United Kingdom