Protocol Number: 03-DK-0132

Title:

The Expression of Connective Tissue Growth Factor and Other Mediators in the Pathogenesis of Chronic Allograft Nephropathy

Number:

03-DK-0132

Summary:

This study will examine whether measurements of connective tissue growth factor (CTGF) and other cell proteins can identify which kidney transplant recipients are likely to develop chronic allograft nephropathy (CAN), a disease of the transplanted kidney. CAN may occur months to years after the transplant. The kidney becomes progressively scarred and eventually loses all function, so that dialysis or another transplant is needed. A better understanding of how CTGF and other proteins are involved in the development of CAN may provide new targets for treating for the disease.

Patients who are scheduled to receive a kidney or combined kidney-pancreas transplant or who have received a transplant recently (within 6 months) may be eligible for this study. Participants will be enrolled before the transplant, if possible, or after the transplant, and will undergo the following tests and procedures:

- Physical examinations at the screening visit, at 1, 6, 12, and 24 months, and then once yearly.

- Blood sample collections at the screening visit, at 1, 6, 12, 18, and 24 months and then once yearly.

- Urine sample collections at the screening visit, at 1, 6, 12, 18, and 24 months and then once yearly.

- Kidney biopsies at the beginning of the study, at 1, 6, 12, and 24 months, and then once a year for research purposes. Participants may refuse to have a research biopsy at any time during the study. Also, patients who are having a kidney biopsy for another reason at these time points will not have a second biopsy. The biopsy procedure takes about 15 minutes and is done in the hospital. The patient lies on his or her back and the skin over the transplanted kidney is cleaned with alcohol and iodine. The area is numbed with an injection of an anesthetic, and then a biopsy needle is placed through the kin. The biopsy may be repeated up to three times to get enough tissue to test for CAN. Patients lie flat for 4 hours after the procedure to reduce the risk of bleeding, and are observed for another 2 hours for possible complications.

Sponsoring Institute:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Recruitment Detail

Type: Active Accrual Of New Subjects

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): None

Eligibility Criteria:

INCLUSION CRITERIA:

Recipients of living related, living unrelated, and cadaveric kidney transplants.

This study will be open to all patients currently enrolled in NIDDK transplant protocols as well as patients recruited from other transplant centers.

Ability and willingness to provide informed consent (adults greater than or equal to 18.0 years) or assent (children 4 to 18.0 years).

EXCLUSION CRITERIA:

Inability to provide informed consent.

Inability to return to NIH for follow-up.

Inability or unwillingness to release outside medical records or pathology.

Special Instructions: Currently Not Provided

Keywords:

TGF-Beta

Kidney

Transplantation

Rejection

Immunosuppression

Recruitment Keywords:

Kidney Transplant

Chronic Allograft Nephropathy

CAN

Conditions:

Kidney Transplantation

Investigational Drug(s):

None

Investigational Device(s):

None

Contacts:

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:

Wolfe RA, et al., Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999 Dec 2;341(23):1725-30. PMID: 10580071

Hariharan S, et al. Improved graft survival after renal transplantation in the United States, 1988 to 1996.

N Engl J Med. 2000 Mar 2;342(9):605-12. PMID: 10699159

Cecka JM. The UNOS renal transplant registry.

Clin Transpl. 2001;:1-18. PMID: 12211771

• Questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.
• Technical questions regarding the Clinical Center web site, please contact the Department of Networks and Applications, CC.

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Bethesda, Maryland 20892. Last update: 10/19/2004