- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03578523
Renal MR Feasibility in Renal Disease (REMIND)
Using MRI ASL Techniques for Quantitative Measurement of Renal Haemodynamics and Structural Parameters in Acute Kidney Injury and Chronic Kidney Disease.
Study Overview
Status
Conditions
Detailed Description
Multi centre observational pilot study using novel, contrast free functional renal MRI scans.
A series of functional renal MRI scans will be performed (These scans do not constitute part patients routine clinical care). The results will initially be used to assess renal perfusion and fibrosis in patients with AKI and CKD. Subsequent analysis will be used to identify specific markers on the renal MRI scans that differentiate chronic kidney damage from acute injury to the kidney. Finally results will be used to stratify patients with AKI and CKD into low and high risk of subsequent deterioration in renal function.
AKI Cohort
25 patients with AKI stage 2/3 with or without renal replacement therapy (RRT) will undergo functional renal MRI imaging at day 0, day 90 and day 365.
First Study Scan (Day 0): A functional renal MRI scan will be performed during an admission to hospital with an episode of AKI 2/3. Vital signs and SOFA score will be recorded on the day of the scan.
Renal function assessment will occur± 2 days either side of the scan with an Iohexol clearance test.
Second Study Scan (Day 90): Repeat functional renal MRI imaging will be planned at 90 days (±14 days) after the 1st study scan day.
Renal function assessment will occur±7 days either side of the scan with an Iohexol clearance test.
Third Study Scan (Day 365): The final functional renal MRI imaging will take place 12 months (±30 days) after the 1st study scan day. Renal function assessment will occur±7 days either side of the scan with an Iohexol clearance test.
CKD Cohort:
25 patients with CKD stage 3-4 eGFR 20-59ml/min/1.73m2 will undergo functional renal MRI imaging at day 0, day 7 and day 365.
First Study Scan (Day 0): A functional renal MRI scan will be performed as an outpatient. Vital signs will be recorded on the day of the scan.
Renal function assessment will occur ±7 days either side of the scan with an Iohexol clearance test.
Second Study Scan (Day 7): A functional renal MRI scan will be performed as an outpatient. Vital signs will be recorded on the day of the scan.
Third Study Scan (Day 365): The second functional renal MRI imaging will take place 12 months (±30 days) after the 1st study scan day. Renal function assessment will occur±7 days either side of the scan with an Iohexol clearance test.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Huda Mahmoud, MBChB
- Phone Number: 01332724365
- Email: huda.mahmoud@nottingham.ac.uk
Study Locations
-
-
East Midlands
-
Derby, East Midlands, United Kingdom, de223ne
- Recruiting
- Royal Derby Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
secondary care patients
- chronic kidney disease stage 3-4 post renal biopsy
- Acute kidney injury stage 2-3 during hospital admission
Description
Inclusion Criteria:
AKI Patients:
- Acute Kidney Injury stage 2/3 (duration >24 hours) including patients requiring renal replacement therapy
- >18 years & < 95 years
- Able to give informed consent
CKD Patients:
- Patients with CKD Stage 3 - 4 (e GFR> 20 and <60 ml/min)
- >18 years & < 95 years
- Able to give informed consent
Exclusion Criteria:
AKI Patients:
- Renal transplant
- Contraindications to MRI e.g. claustrophobia, cardiac pacemaker, metallic fragments or implants
- Pregnancy or breast feeding or intending pregnancy
- Unable to give consent or understand written information
- Pre-existing CKD of any stage as per eGFR
- Obstructive uropathy
- AKI duration <24hrs, in the opinion of the investigator
- Not medically fit for transfer to MRI scan, in the opinion of the clinical team or the investigator
- Iodine allergy
- Patients unable to comply with basic verbal English commands whilst in scanner due to special communication needs
CKD Patients:
- Renal transplant
- Contraindications to MRI e.g. claustrophobia, cardiac pacemaker, metallic fragments or implants
- Pregnancy or breast feeding or intending pregnancy
- Unable to give consent or understand written information
- Unstable CKD; AKI Stage 1 or more or other unplanned hospital admission within the last 90 days
- Iodine allergy
- Patients unable to comply with basic verbal English commands whilst in scanner due to special communication needs
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Chronic Kidney Disease
CKD stage 3-4 eGFR 59-20mls/min/1.73 '3 Tesla multiparametric MR: Renal MRI Scan to assess blood flow, perfusion, oxygenation and microstructure (MR T1 relaxation time and diffusion). Each patient will have 3 renal MRI scans. renal histopathology scoring: Blinded fibrosis scoring of renal histopathology (If biopsy performed for clinical indication) Iohexol clearance test: Blood and urine sampling around scan sessions; this will include routine patient care biochemistry and haematology panel. urine protein and albumin measurements, stored plasma/serum/urine for subsequent analysis. Iohexol clearance to measure GFR within 1 week of the scan session |
Renal MRI Scan to assess blood flow, perfusion, oxygenation and microstructure (MR T1 relaxation time and diffusion).
Each patient will have 3 renal MRI scans.
Other Names:
Blinded fibrosis scoring of renal histopathology (If biopsy performed for clinical indication)
Blood and urine sampling around scan sessions; this will include routine patient care biochemistry and haematology panel, urine protein and albumin measurements, stored plasma/serum/urine for subsequent analysis
Iohexol clearance to measure GFR within 1 week of the scan session
|
Acute Kidney Injury
AKI stage 2-3 '3 Tesla multiparametric MR: Renal MRI Scan to assess blood flow, perfusion, oxygenation and microstructure (MR T1 relaxation time and diffusion). Each patient will have 3 renal MRI scans. Iohexol clearance test: Blood and urine sampling around scan sessions; this will include routine patient care biochemistry and haematology panel. renal histopathology scoring: Blinded fibrosis scoring of renal histopathology (If biopsy performed for clinical indication) urine protein and albumin measurements, stored plasma/serum/urine for subsequent analysis. Iohexol clearance to measure GFR within 1 week of the scan session |
Renal MRI Scan to assess blood flow, perfusion, oxygenation and microstructure (MR T1 relaxation time and diffusion).
Each patient will have 3 renal MRI scans.
Other Names:
Blinded fibrosis scoring of renal histopathology (If biopsy performed for clinical indication)
Blood and urine sampling around scan sessions; this will include routine patient care biochemistry and haematology panel, urine protein and albumin measurements, stored plasma/serum/urine for subsequent analysis
Iohexol clearance to measure GFR within 1 week of the scan session
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The difference between volume (mls) MR parameter between healthy volunteers and patients with CKD and AKI
Time Frame: 3 years
|
Examining the difference in volume (mls) T1 (ms) between the 3 groups using PRISM, SPSS, Stata and Matlab
|
3 years
|
The difference between T1 (ms) MR parameter between healthy volunteers and patients with CKD and AKI
Time Frame: 3 years
|
Examining the difference in T1 (ms) between the 3 groups using PRISM, SPSS, Stata and Matlab
|
3 years
|
The difference between Diffusion weighted imaging MR parameter between healthy volunteers and patients with CKD and AKI
Time Frame: 3 years
|
Examining the difference in ADC and D(ms) between the 3 groups using PRISM, SPSS, Stata and Matlab
|
3 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlations between structural T1 (ms) and blinded renal biopsy measurements
Time Frame: 3 years
|
Sirius red fibrosis scoring (%) Vs T1(ms)
|
3 years
|
Correlations between structural MR measurement: T1(ms) and creatinine(µmols),
Time Frame: 3 years
|
T1 (ms) vs creatinine (µmols)
|
3 years
|
Correlations between structural diffusion weighted imaging and blinded renal biopsy measurements
Time Frame: 3 years
|
Sirius red fibrosis scoring (%) Vs ADC and D (ms)
|
3 years
|
Correlations between structural MR measurement: diffusion weighted imaging and eGFR mls/min.1.73m
Time Frame: 3 years
|
ADC and D (ms) vs eGFR mls/min.1.73m
|
3 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Maarten Taal, univeristy of nottingham
- Study Chair: nick selby, University of Nottingham
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 15040
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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