Application of Functional Renal MRI to Improve Assessment of Chronic Kidney Disease (AFiRM)
Research question: Can multiparametric renal Magnetic Resonance Imaging (MRI) provide structural and functional assessment of the kidneys to deliver prognostic information and guide treatment options in chronic kidney disease (CKD)?
Aims and objectives:
- To establish a multiparametric renal MRI protocol in CKD cohorts.
- To use multiparametric MRI to characterise people with and without CKD progression.
- To compare multiparametric renal MRI with 'gold-standard' renal biopsy to determine pathological processes of CKD progression that are detectable by MRI.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The study will have three stages.
Stage 1: 45 people with CKD from nine UKRIN centres will undergo multiparametric MRI to test patient tolerance, data completeness and central data collection processes.
Stage 2: A multicentre, prospective cohort study of 450 people with CKD, collecting multiparametric renal MRI at baseline and 2 years. Long-term outcomes will be determined with efficient tracking of kidney failure events via the UK Renal Registry at 5 and 10 years.
Stage 3: A mechanistic sub-study of 45 patients (from Stage 2) who have had a routine renal biopsy. Detailed comparisons will be made between multiparametric MRI and histopathological changes. Tissue blocks will undergo quantitative analysis of fibrosis, capillary density and inflammation using immunohistochemistry techniques.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
Derbyshire
-
Derby, Derbyshire, United Kingdom, DE22 3NE
- Royal Derby Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria
- Age 18-75 years
- CKD category G3-4 or CKD category G1-2 with overt albuminuria (urine ACR>30mg/mmol)
- Capable of giving informed consent
Exclusion Criteria
- Autosomal dominant polycystic kidney disease (ADPKD)
- Glomerulonephritis (GN) actively receiving immunosuppression, or within the preceding 90 days.
- Multiple myeloma (MM)
- Acute Kidney Injury (AKI) within the preceding 90 days
- Solid organ transplant
- Known single kidney
- Contraindications to MRI (e.g. permanent pacemaker, metallic foreign bodies, claustrophobia etc.)
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Main study cohort
Patients with CKD recruited from specialist nephrology clinics
|
Localiser scans; Kidney volume; Longitudinal (T1) relaxation time mapping; Diffusion weighted imaging (DWI); Phase Contrast MRI; Arterial spin labelling (ASL); Blood Oxygen Level Dependent (BOLD) mapping
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
CKD progression
Time Frame: 10 years
|
kidney failure (doubling of serum creatinine, eGFR<15ml/min or RRT) OR a 40% decline in eGFR
|
10 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Kidney failure events
Time Frame: 10 years
|
Doubling of serum creatinine, eGFR<15ml/min or RRT
|
10 years
|
|
40% decline in eGFR from baseline
Time Frame: 10 years
|
10 years
|
|
|
eGFR trajectory
Time Frame: 2 years
|
(ml/min/yr)
|
2 years
|
|
AKI events
Time Frame: 4 years
|
AKI as per KDIGO serum creatinine criteria
|
4 years
|
|
Cardiovascular events
Time Frame: 4 years
|
4 years
|
|
|
All cause mortality
Time Frame: 10 years
|
10 years
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Renal MRI measures
Time Frame: 2 years
|
As detailed in interventions section
|
2 years
|
|
Renal histology measures
Time Frame: Baseline
|
Glomerulosclerosis score, extent of interstitial fibrosis, inflammation, peritubular capillary density, collagen accumulation, inflammatory cell subtypes
|
Baseline
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Urogenital Diseases
- Pathologic Processes
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Chronic Disease
- Disease Attributes
- Renal Insufficiency
- Pathological Conditions, Signs and Symptoms
- Renal Insufficiency, Chronic
Other Study ID Numbers
Other Study ID Numbers
- DHRD/2018/100
- 271043 (Other Identifier: IRAS)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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