Status:

WITHDRAWN

Kidney Allograft Dysfunction Without Reversible Causes

Lead Sponsor:

University of Minnesota

Conditions:

Kidney Graft Dysfunction

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

The purpose of this study is to learn the best way to prolong kidney life in patients exposed to calcineurin inhibitors, who already have evidence of damage possibly caused by the calcineurin inhibito...

Eligibility Criteria

Inclusion

  • Serum creatinine increased greater than or equal to 25% over baseline with no acute or reversible cause clinically evident.
  • Although eGFR is arguably better for estimating kidney allograft function than serum creatinine, pragmatics dictate the use of a change in serum creatinine in the initial selection of patients. These criteria are currently used by transplant coordinators for selection of patients for the kidney biopsy as a part of large on-going study at our center.
  • Adequate (greater than or equal to 8 glomeruli) biopsy showing Chronic allograft injury reported as mild/moderate CAN or CNI toxicity based on the previously used Banff 97 classification and no potentially reversible causes of graft dysfunction, e.g. acute rejection or treatable recurrent disease. Patients with histological evidence of mild recurrent disease that does not appear to be severe enough to explain the deterioration in function, e.g. IgA on immunofluorescence, or changes consistent with early diabetic nephropathy, will not be excluded.
  • Receiving CsA (trough level concentration 75-125 ng/mL) or Tacrolimus(trough level concentration 6-12 ng/mL) plus MMF (or AZA) with (or without) prednisone.
  • Able to give informed consent.

Exclusion

  • Urine total protein excretion \>500 mg/g creatinine.
  • eGFR (estimated by MDRD) \<40 mL/min/1.73 m2
  • Triglycerides \>400 mg/dL or total cholesterol \>300 mg/dL
  • Allergy to macrolide antibiotic or rapamycin
  • Women of child-bearing potential not using effective contraception
  • Treated for acute rejection within the past 2 months
  • \<12 months after transplantation
  • Potentially treatable cause(s) of allograft dysfunction, including acute rejection, dehydration, and congestive heart failure.
  • Recurrent or de novo kidney disease that is histologically severe enough to be causing graft dysfunction
  • Polyoma virus (BK) nephropathy, or serum positive for BK by polymerase chain reaction
  • A second, functioning organ transplant.
  • Receiving sirolimus.
  • Patients with any past or present malignancy (other than non-melanoma skin cancer)

Key Trial Info

Start Date :

January 1 2008

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

October 1 2011

Estimated Enrollment :

Patients enrolled

Trial Details

Trial ID

NCT01492894

Start Date

January 1 2008

End Date

October 1 2011

Last Update

December 9 2016

Active Locations (1)

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1

University of Minnesota Departments of Medicine and Surgery

Minneapolis, Minnesota, United States, 55455