Kidney Disease and Ultrasound Imaging (Imag-NCT)
Non-invasive Diagnosis of Chronic Kidney Disease in Renal Transplants Kidney Transplanted Using Ultrasound Functional Imaging
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Kidney transplant patients are exposed to long-term immunosuppressive therapy, and have an increased risk of infections and cancer, while a lack of treatment increases the risk of rejection. The development of imaging techniques to characterize the status of the graft remains a challenge in transplantation. Ideally, they should identify complications (acute rejection, chronic allograft nephropathy, nephrotoxicity ...) without the need for invasive procedures and thus lead to better customization of immunosuppressive therapy.
The post-transplant follow-up is based on the monitoring of graft function. Impaired function suggests the possibility of a complication, but requires confirmation by an invasive procedure such as renal biopsy. In addition, the diagnosis remains complex at a relatively advanced stage of the process due to damage to the graft parenchyma. To anticipate the altered function and detect subclinical lesions, screening biopsies have been used to diagnose chronic rejection. By definition, screening for subclinical lesions can not be based on any biological parameter; the diagnosis of subclinical complications thus requires performing multiple systematic biopsies, which are scheduled at 3 months and 1 year.
Doppler ultrasound is an imaging method of choice for the study of renal transplant, but it cannot diagnose the NCT due to the absence of specific findings. The lack of early diagnostic test for NCT is a major obstacle to the development and evaluation of new therapeutic options to prevent, slow or stabilize renal fibrosis. It is therefore necessary to develop a non-invasive imaging technique for the early diagnosis of NCT.
Ultrasound elastography is a technique that allows tissue stiffness measurements and provides a parametric picture.
The main objective of our study is to evaluate the performances of elastography and measurement of renal perfusion (area under the ROC curve) to diagnose the NCT and determine for each both measures a threshold to maximize the sensitivity. These performances will be evaluated at 3 months and 12 months. The results can also be compared to other imaging modalities such as functional MRI, and to clinical events (obstruction, infection…).
Functional ultrasound imaging should identify diagnostic and prognostic criteria of NCT, and enable the development of less invasive therapeutic protocols to evaluate new therapeutic approaches
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Paris, France, 75015
- Necker Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years;
- Patient with informed consent;
- Recipient of a living donor graft or cadaveric donor patient;
- No contraindication for biopsy of the graft;
No contraindication to the injection of SonoVue ®:
- hypersensitivity to sulfur hexafluoride
- acute coronary syndrome, unstable ischemic heart disease (myocardial infarction phase formation or evolution, typical resting angina in the previous 7 days, significant worsening of cardiac symptoms in the previous 7 days, recent intervention on the coronary arteries or another factor suggesting clinical instability (eg, recent deterioration of ECG changes in clinical or laboratory parameters), acute heart failure, stage III or IV heart failure, severe arrhythmias.
- right-left shunt, severe pulmonary hypertension (PAP> 90 mmHg), uncontrolled systemic hypertension, respiratory distress syndrome
- Affiliated to a social security scheme
Exclusion Criteria:
- Refusal to participate in the study;
- Inability / refusal to give informed consent;
- contraindication for biopsy testing graft;
- Presence of a contraindication to the injection of SonoVue ®.
- Presence of a peripheral venous access in a non-restricted already infused patient, not pickable under ultrasound
- Breastfeeding, pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Imag-NCT
The ultrasound functional imaging will be performed at J15 (before the patient is discharged from service Transplantation) and at 3 and 12 months after the transplant. The functional imaging examinations will be held as follows:
Renal biopsy will be performed after the functional ultrasound at 3 and 12 months. |
Renal biopsy will be performed at 3 and 12 months. The functional imaging examinations will be held as follows: Step 1: the conventional Doppler ultrasound Step 2: ultrasound elastography Step 3: CEUS |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
renal Elastography
Time Frame: 3 months
|
The assessment of renal function is performed by the serum creatinine and calculation of glomerular filtration rate estimated by the formula Modified Diet in Renal Disease (MDRD) 4-parameter at 3 and 12 months post-transplantation. In addition, a measure of glomerular filtration rate using the technique to iohexol is performed routinely at 12 months post-transplant as part of routine monitoring of transplant patient. The ultrasound functional imaging will be performed at 15 days, 3 and 12 months after transplantation. The functional imaging examinations will be held as follows: Step 1: the conventional Doppler ultrasound 2nd step: the ultrasound elastography Step 3 : CEUS |
3 months
|
|
Renal Elastography and contrast-enhanced US
Time Frame: 12 months
|
The assessment of renal function is performed by the serum creatinine and calculation of glomerular filtration rate estimated by the formula Modified Diet in Renal Disease (MDRD) 4-parameter at 3 and 12 months post-transplantation. In addition, a measure of glomerular filtration rate using the technique to iohexol is performed routinely at 12 months post-transplant as part of routine monitoring of transplant patient. The ultrasound functional imaging will be performed at 15 days, 3 and 12 months after transplantation. The functional imaging examinations will be held as follows: Step 1: the conventional Doppler ultrasound 2nd step: the ultrasound elastography Step 3 : CEUS |
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
renal Elastography
Time Frame: 3 months
|
Correlation between elastography and renal function with degree of fibrosis and renal function will be calculate using Pearson coefficient of correlation
|
3 months
|
|
Correlation between renal elastography and perfusion and degree of fibrosis and renal function
Time Frame: 12 months
|
Correlation between elastography and renal function with degree of fibrosis and renal function will be calculate using Pearson coefficient of correlation
|
12 months
|
|
renal Elastography in patients with chronic kidney disease
Time Frame: 12 months
|
this two measures will be express in evolution percentage at J15 and 3 months.
The evolution percentage will be compared with imaging of patient with chronic kidney disease to determine if elastography and renal perfusion can predict chronic kidney disease at one year.
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Jean-Michel CORREAS, PUPH, Necker Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2012-A01070-43
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Recipient of Kidney Transplant
-
NCT00189150CompletedKidney Transplant Recipient | Heart Transplant Recipient
-
NCT06858098Not yet recruitingKidney Transplant | Kidney Transplant Recipient | Kidney Transplant Donor
-
NCT05975450CompletedKidney Transplant Recipient
-
NCT06860139Active, not recruitingTransplant Recipient (Kidney)
-
NCT02474199CompletedLiver Transplant Recipient | Living Donor (of the Respective Liver Transplant Recipient)
-
NCT07621835CompletedKidney Transplant | Kidney Transplant Recipient | CMV Specific Immune Response | CMV Reactivation
-
NCT06011850CompletedKidney Transplant Recipient | Kidney Transplant Donor
-
NCT03504241CompletedKidney Transplantation | Renal Transplantation | Renal Transplant Recipient
-
NCT03697317CompletedPhysical Activity | Diet Modification | Kidney Transplant Recipient
-
NCT00307125CompletedKidney Transplant | Kidney Transplant Recipient | Graft Function/Survival | de Novo HLA Antibodies Development
Clinical Trials on renal echography
-
NCT01109225CompletedMyocardial Infarction
-
NCT01785238CompletedNeonatal Acute Renal Failure in Preterm
-
NCT01436409Completed
-
NCT00797537CompletedChondrocalcinosis | Articular Cartilage Calcification
-
NCT05345665Completed
-
NCT00639028Completed
-
NCT06958809Not yet recruitingSeptic Shock | Fluid Resuscitation | Congestion, Venous
-
NCT06587893CompletedSuprascapular Nerve Block
-
NCT04935996Not yet recruiting
-
NCT06743139CompletedAnalyze the Results of Cardiorespiratory Stress Tests | Resting and Stress Echocardiography | Capillary Lactatemia Measurements at the Ear