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Completed

NCT Number: NCT04223206

Innovative Functional Food Based on Apulian Lens Culinaris for Contrasting Sarcopenia in Dialysis Patients

The objective of the pilot study is to validate the clinical use of a dietary supplement for contrasting sarcopenia in dialysis patients.

The study aims at evaluating the effects of a nutritional supplement, consisting of flour from Lens culinaris of Altamura IGP, pea proteins and vitamins (A, B12, D, E) by achieving the following objectives:

* Reduction of sarcopenia conditions, through improvement of nutritional and anthropometrical levels * Decrease of the serum levels of microbiota-derived uremic toxins * Reduction of intestinal permeability and inflammatory markers

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Key information

Age range

60 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

AOUConsorziale Policlinico Di Bari

Bari, 70124, Italy

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • patients > 60 years old
  • omnivore controlled normocaloric diet (30 Kcal/kg ideal weight)
  • patients with chronic kidney disease (CKD) and routine hemodialysis or peritoneal dialysis
  • patients with primary sarcopenia identified with score ≥ 4 at SARC-F Questionnaire
  • informed consent signed

Exclusion criteria

  • participation to another clinical trial
  • limb removal by amputation
  • altered blood sugar level (HbA1c>8.0%) or type I diabetes mellitus
  • neoplastic events in the last 5 years
  • gut, systemic or autoimmune chronic inflammatory pathologies
  • use of antibiotics or probiotics up to 30 days prior to recruitment
  • life expectancy of less than one year
  • treatment with corticosteroids or immunosuppressive drugs (excluded prednisone at dose <5 mg at day)
  • positivity to hepatitis B and C virus, HIV1/2 and syphilis
  • oxygen saturation in the blood at rest <93%
  • alcohol or drug abuse in the last 3 years
  • clinically important alterations of the following laboratory parameters: hemoglobin <9.0 g / dL, white blood cells <2.500 / μl, platelet count <100.000 / μl, AST and ALT> 3 times the upper limit of the norm, coagulopathy (INR> 1.3 ) not due to a reversible cause (eg Warfarin and / or factor Xa inhibitors)
  • uncontrolled hypertension (resting systolic blood pressure> 180 mmHg or diastolic blood pressure> 110 mmHg)
  • unstable angina pectoris, severe peripheral artery disease, coronary bypass surgery, angioplasty or acute major cardiocirculatory diseases in the previous 3 months
  • definite congestive heart failure class III or IV (NYHS) or ejection fraction <25%
  • severe pulmonary dysfunction: acute exacerbation of chronic obstructive pulmonary disease in phase III or IV (Gold classification) and / or PaO2 levels <60 mmHg
  • significant intestinal malabsorption due to partial ileal bypass or other causes
  • score ≤ 24 at the Mini Mental State Examination (MMSE) or presence of cognitive or linguistic limits that prohibit informed consent or possible elements of study
  • diagnosis of disabling neurological disorder, including Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, cerebrovascular accident with residual deficits (for example, muscle weakness or gait disorder), dementia or any psychiatric condition that reduces protocol compliance
  • have a history or evidence of any condition, therapy, laboratory abnormality or other circumstances that could confuse the results of the study or interfere with the patient's participation throughout the duration of the study

Treatment and study plan

NATURLENS

Dietary Supplement

Oral administration of dietary supplement (26 g/day) to dissolve in 100 or 150 mL of water

Primary outcomes

  1. Evaluation of muscle mass

    Time frame: 3 months

    Change of muscle mass by bioelectrical impedance assessment (BIA)

Secondary outcomes

  1. Change of sarcopenia conditions

    Time frame: 3 months

    Change of sarcopenia assessed by the European Working Group on Sarcopenia in Older People (EWGSOP) guidelines through the SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) questionnaire. The SARC-F scale scores range from 0 to 10 (i.e. 0-2 points for each item; 0=best to 10=worst) and represents no sarcopenia (0-3) and sarcopenia (4-10).

  2. Change of Mini Nutritional Assessment (MNA) score

    Time frame: 3 months

    Measurement of MNA questionnaire (12-14 points, normal nutritional status; 8-11 points, at risk of malnutrition; 0-7, malnourished)

  3. Change of anthropometric parameter

    Time frame: 3 months

    Measurement of the arm circumference (cm)

  4. Change of body mass index (BMI)

    Time frame: 3 months

    Measurement of BMI (kg/m^2)

  5. Change of gastrointestinal symptoms

    Time frame: 3 months

    Change of gastrointestinal symptoms assessed by Gastrointestinal Symptom Rating Scale (GSRS) questionnaire (15 items scored 1-7 each, 1 representing the best and 7 the worse outcome for each item).

  6. Change of stool type

    Time frame: 3 months

    Change of stool type evaluated by BRISTOL Stool Scale (range 1-7, lower and higher values representing worse outcome, middle values representing better outcome).

  7. Change of serum concentration of IS and pCS

    Time frame: 3 months

    Change of free and total indoxyl sulfate (IS) and p-cresyl sulfate (pCS) serum concentrations (μg/mL) assessed by liquid chromatography/mass spectrometry

  8. Change of serum concentration of inflammatory markers

    Time frame: 3 months

    Change of serum concentrations of interleukins: IL-6, TNF-α, IL-1, IL-8, IL-10 (pg/mL) evaluated by ELISA

  9. Change of blood glucose level

    Time frame: 3 months

    Change of glycemia concentration (mg/dl)

  10. Change of insulin levels

    Time frame: 3 months

    Change of insulin concentration (pmol/L)

  11. Change of endocrine parameters

    Time frame: 3 months

    Change of C-peptide, growth hormone (GH), insulin-like growth factor 1 (IGF-1), testosterone concentration (ng/mL)

  12. Change of serum concentration of D-lactate

    Time frame: 3 months

    Change of D-lactate serum concentration (uM)

Other outcomes

  1. Gut microbiota

    Time frame: 3 months

    Change of the relative abundance (%) of Operational Taxonomic Units (OTUs) of Firmicutes, Bacteroidetes,Proteobacteria, Verrucomicrobia, Actinobacteria, Synergistetes, Cyanobacteria, Euryarchaeota, Chloroflexi, Nitrospirae, Tenericutes, Fusobacteria, Thermotogae, Acidobacteria evaluated by fecal bacterial DNA genome sequencing.

Sponsors and collaborators

Lead sponsor

Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari

Other

Collaborators

  • University of Bari Aldo Moro

Registry information

Official study title

K2DTD75 - ALTIS "Alimento Funzionale a Base di Lens Culinaris Tipico Del Territorio Pugliese ed Innovativo Per la Salute" - Regione Puglia "INNONETWORK 2017"

Acronym: ALTIS

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Jan 10, 2020
Registry last updated
Feb 3, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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