ISRCTN ISRCTN35143689
DOI https://doi.org/10.1186/ISRCTN35143689
Secondary identifying numbers S 131-03
Submission date
09/10/2007
Registration date
18/12/2007
Last edited
18/12/2007
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Hans Herlitz
Scientific

Department of Nephrology
Sahlgrenska University Hospital
Göteborg
413 45
Sweden

Phone +46 31 3428477
Email hans.herlitz@medic.gu.se

Study information

Study designA two-center randomized controlled open study.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeNot Specified
Scientific title
Study acronymCARLAS
Study objectivesDespite beneficial effects on blood pressure with endovascular treatment, the prognosis remains ominous in patients with renal artery stenosis because of increased cardiovascular mortality. In patients with atherosclerotic renal artery stenosis, the mortality is increased six-fold compared to an age-matched population. It is reasonable to speculate that the high cardiovascular mortality in patients with renal artery stenosis could partly be explained by increased inflammatory activity caused by activation of the renin-angiotensin system. We believe that Percutaneous Transluminal Renal Angioplasty (PTRA) followed by angiotensin receptor blockade may improve this disease state.

The angiotensin receptor blocker candesartan given to patients with renovascular hypertension post-PTRA, will improve long-term renal function (3 years) and decrease the risk of restenosis.
Ethics approval(s)Approved by the Ethical Committees of the Universities of Göteborg and Lund on the 14th of April 2003.
Health condition(s) or problem(s) studiedRenal artery stenosis
InterventionThis study is carried out at two centers in Sweden (Göteborg and Malmö).

Four weeks after renal angioplasty, all subjects will be randomized to anti-hypertensive treatment with either candesartan (oral) (intervention group) or conventional anti-hypertensive treatment (control group). The choice of drug used for the treatment of each participant in the control group will depend on his/her condition. The choices are betablockers, calcium antagonists, diuretics and alphablockers.

The maximum daily doses: 200 mg for metoprolol (betablocker), 20 mg for felodipine (calcium antagonist), as much as needed for furosemide (diuretic), 8 mg for doxazosin (alphablocker). Candesartan was titrated up to a dose of 16 mg once daily.

Duration of intervention: three years
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Candesartan
Primary outcome measureRenal function measured by EDTA-clearance and frequency of restenosis 3 years after PTRA.
Secondary outcome measuresCardiovascular events 3 years after PTRA.
Overall study start date15/04/2003
Completion date31/12/2007

Eligibility

Participant type(s)Patient
Age groupNot Specified
SexBoth
Target number of participants200
Key inclusion criteria1. Blood pressure above 140 mmHg/90 mmHg
2. Confirmation of renal artery stenosis by either duplex ultrasonography, CT-angiography or MR-angiography
Key exclusion criteria1. Renal size <7.5 cm at the stenotic side
2. Age >80 years
3. Pregnancy or nursing mother
4. Terminal renal failure (Glomerular Filtration Rate [GFR] <15 ml/min)
5. Treatment with Angiotensin-Converting Enzyme (ACE) inhibitors or angiotensin receptor blockers
6. Renovascular hypertension of other etiology than atherosclerosis or Flow-Mediated Dilation (FMD)
7. Chronic glomerular disease with urinary albumin excretion (in mg/24h) (tU-alb) >1g/day
8. Diabetic nephropathy with tU-alb >0.3 g/day
9. Contraindication for renal angiography/PTRA (eg. serious contrast allergy)
10. Other forms of secondary hypertension
11. Serious malignant disease
12. Treatment with immune-modulating medications eg. cyclosporin and oral steroids
Date of first enrolment15/04/2003
Date of final enrolment31/12/2007

Locations

Countries of recruitment

  • Sweden

Study participating centre

Department of Nephrology
Göteborg
413 45
Sweden

Sponsor information

AstraZeneca (Sweden)
Industry

Argongatan 2D
Mölndal
431 86
Sweden

Phone +46 31 7788500
Email mikael.forsby@astrazeneca.com
ROR logo "ROR" https://ror.org/04wwrrg31

Funders

Funder type

Industry

The Ernhold Lundström Foundation (Sweden)

No information available

Research Funds at Malm General (University) Hospital (Malm Allmnna Sjukhus - MAS) (Sweden)

No information available

The Albert Påhlsson Foundation (Sweden)

No information available

The Hulda Ahlmroth Foundation (Sweden)

No information available

The Göteborg Medical Society (Sweden)

No information available

The Swedish Medical Society

No information available

The Swedish Association for Kidney Patients

No information available

AstraZeneca, Mölndal (Sweden)

No information available

The Swedish state under the LUA/ALF agreement

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan