- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04769778
Renin Angiotensin System Blockade in Renal Transplant Patients With Presence of PECs in Urine
May 17, 2021 updated by: Josep M Cruzado
By means of a personalized medicine strategy, investigators are going to evaluate if the treatment with an angiotensin II receptor antagonist (ARAII) in renal transplant patients with the presence of renal progenitor cells (PECs) in the urine is able to prevent the expected loss of glomerular filtration (GFR) observed in this subgroup of patients.
In addition, investigators intend to deepen the mechanisms of glomerular damage and glomerular repair involved in the process of chronic allograft damage.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
A randomized, double-blind clinical trial will be performed in renal transplant patients in month 6 post-transplant, at the time of protocol renal biopsy.
After verifying the inclusion and exclusion criteria, informed consent will be obtained.
Patients with urinary PECs will be randomized to 80 mg of valsartan vs. placebo (sample size calculated for a superiority study, 45 patients per group).
Patients without PECs in urine will be followed according to usual clinical practice.
The follow-up will be up to 2 years post-transplant.
At baseline (6 m post-transplant) and at 2 years the GFR will be measured by means of iohexol clearance (main variable) and, in addition, we will analyze safety variables such as patient and graft survival and RAGIs.
By means of morphometry techniques on renal biopsy and by measuring the renal cortical volume by high resolution CT, the number of glomeruli will be determined, which in turn, will allow to calculate the SN-GFR.
Finally, in 5 patients per study group and in 5 controls, PECs of renal tissue will be isolated by means of laser microdissection techniques to perform single-cell RNA sequencing techniques to assess the molecular pathways involved in the glomerular damage and repair process and how the RAAS blockade modifies such molecular pathways.
Study Type
Interventional
Enrollment (Anticipated)
180
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: JOSEP M CRUZADO, MD, PhD
- Phone Number: 932607385
- Email: jmcruzado@bellvitgehospital.cat
Study Contact Backup
- Name: Carolina Polo, PhD
- Phone Number: +34 93 260 73 85
- Email: cpolo@idibell.com
Study Locations
-
-
Barcelona
-
L'Hospitalet de Llobregat, Barcelona, Spain, 08907
- Recruiting
- Nephrology Department. Hospital Universitari de Bellvitge
-
Contact:
- Josep M Cruzado, Medical Doctor
- Phone Number: 0034932607602
- Email: 27541jcg@comb.es
-
Contact:
- CAROLINA POLO, PhD
- Phone Number: 932607385
- Email: cpolo@idibell.cat
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Written informed consent
- Stable renal function understood as a variation of eGFR of less than 15% in the last 3 months
- Immunosuppression maintenance based on tacrolimus and MMF / MPA
Exclusion Criteria:
- Chronic active infection by HCV, HBV, HIV.
- Treatment with inhibitors of the renin angiotensin system.
- Double kidney transplant or combined with another organ.
- Immunosuppression of maintenance other than tacrolimus and MMF / MPA.
- eGFR <20 ml / min / 1.73m2.
- History of allergy or intolerance to inhibitors of the renin angiotensin system.
Physically fertile women who plan to become pregnant, are pregnant and
/ or breast-feeding, or who do not want to use effective contraception during their participation in the study.
- Any other medical condition that, in the opinion of the investigator, based on the counting or review of clinical records, could affect the completion of the study, including, but not limited to, visual problems or cognitive impairment.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Valsartan
Treatment with valsartan
|
treatment with 80mg /day of valsartan
|
No Intervention: no treatment
no treatment received
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
prevention of fall of glomerular filtration rate
Time Frame: 12 months
|
To assess whether treatment with an angiotensin II receptor antagonist (AIIRA) prevents the fall of glomerular filtration in the subgroup of kidney transplant patients with presence of PECs in urine.
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SN-GFR
Time Frame: 12 months
|
Compare the SN-GFR (nephron glomerular filtration rate)
|
12 months
|
Single cell RNA sequencing
Time Frame: 12 months
|
Carry out single cell RNA sequencing studies using cell microdissection techniques of PEC cells isolated from renal biopsies performed at 6 and 24 m after transplantation in patients without uPECs and in patients with uPECs included in the therapeutic intervention study.
These studies will allow us to know the changes of gene expression in PECS cells that can be associated with the favorable response in treated or untreated patients.
|
12 months
|
podocyturia
Time Frame: 12 months
|
To determine the influence of the treatment on podocyturia and the preservation of the number of podocytes at 2 years post transplant.
|
12 months
|
graft survival
Time Frame: 12 months
|
Evaluate the influence of treatment on graft survival
|
12 months
|
patient survival
Time Frame: 12 months
|
Evaluate the influence of treatment on patient survival and proteinuria.
|
12 months
|
Chronic Glomerular Lessions
Time Frame: 12 months
|
Evaluate the influence of treatment on number of participants with chronic glomerular lesions.
|
12 months
|
Suspected Unexpected Serious Adverse Reaction (SUSAR) reporting unexpected serious adverse reactions)
Time Frame: 12 months
|
Evaluate the safety of the treatment on the number of patients with Suspected Unexpected Serious Adverse Reaction (SUSAR) reporting unexpected serious adverse reactions) unexpected adverse reactions) and rate of treatment discontinuations.
|
12 months
|
Proteinuria
Time Frame: 12 months
|
Evaluate the influence of treatment on measure of proteinuria
|
12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 19, 2020
Primary Completion (Anticipated)
June 1, 2023
Study Completion (Anticipated)
June 1, 2023
Study Registration Dates
First Submitted
January 7, 2021
First Submitted That Met QC Criteria
February 21, 2021
First Posted (Actual)
February 25, 2021
Study Record Updates
Last Update Posted (Actual)
May 19, 2021
Last Update Submitted That Met QC Criteria
May 17, 2021
Last Verified
May 1, 2021
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PRONE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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