Fractures and Bone Disease in Living Kidney Donors
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- Mayo Clinic
- 入组人数
- 4,415
- 试验地点
- 1
- 主要终点
- Evaluate bone health and bone fracture incidence in kidney donors and non-kidney donors
研究概览
简要总结
This research study is being done to measure bone health in living kidney donors and compare them to non-kidney donors to learn if living kidney donors have a higher risk of bone fractures (breaks) after kidney donation. Certain chemicals in the body that help maintain bone health were shown to have changed after kidney donation in living donors, whether or not these changes lead to a decrease in bone quality and increase the risk of fractures is not known.
The purpose of this study is to compare the bone health of living kidney donors, with the bone health of non-kidney donors. This information will be helpful in informing future kidney donors of the risks of donation and in creating treatments to help prevent these complications.
详细描述
This is an observational study that consists of two Aims:
Aim 1 is a survey sent to 3000 prior living kidney donors and 3000 matched controls. The survey contains questions about history of bone fractures and general bone health. Prior living kidney donors will be identified and surveyed from three Minnesota centers: Mayo Clinic, Rochester; Hennepin County Medical Center (HCMC); and the University of Minnesota (UMN).
Aim 2 of this study includes an assessment of bone structure and bone turnover markers in a subset of donors and matched controls. 200 prior living kidney donors and 200 matched controls will be invited to Mayo Clinic Rochester's CRTU for an assessment of bone health. Each subject will undergo lateral DXA with VFA assessment, bone density assessment of each hip, radius and spine by DXA scan, bone structure assessment by HRpQCT of the distal radius and tibia, finite element assessment(µFEA), skin AGEs measurement, and blood collection to measure markers of bone formation and resorption.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aim 1: Survey (Donors):
- •Donated a kidney at one of the three participating sites.
- •10 or more years have passed since donation.
- •Age ≥ 50 at time of study enrollment.
- •Aim 1: Survey (Controls):
- •Subjects in the REP population.
- •Medical records available for the five years preceding age at matching (age at donation).
- •Matching will be based on: age, year of donation, sex, race/ethnicity, body mass index, comorbidity and selected risk factors (smoking, education level) status at year of donation
- •Aim 2: Skeletal health assessment (Donors and Controls):
- •Subjects who have completed the survey
- •Willing to come in for the in-person assessment
排除标准
- •Aim 1: Survey (Donors):
- •Not willing to return the survey.
- •Aim 1: Survey (Controls):
- •Not willing to return the survey
- •History of the following conditions:
- •Diabetes mellitus, liver disease, kidney disease, nephrolithiasis, malabsorption syndrome, past history of non-traumatic fractures.
- •Aim 2: Skeletal health assessment (Donors and Controls):
- •Subjects who did not participate in the survey
- •Subjects not willing to come for the in-person evaluation.
- •Women of childbearing potential.
结局指标
主要结局
Evaluate bone health and bone fracture incidence in kidney donors and non-kidney donors
时间窗: Baseline
Measured by participant self-report response to survey about bone fractures and bone health survey
Incidence of differences in bone architecture and strength after kidney donation
时间窗: Day 1
By comparisons of kidney donors and non-donors in measures of volumetric density and bone microarchitecture at the distal radius and tibia by high-resolution peripheral quantitative computed tomography (HR-pQCT). Bone strength will be evaluated using Image Processing Language (IPL) software to generate microfinite element (μFE) models from HR-pQCT imaging.
Assess the correlations of bone biomarker and serum hormone concentrations with bone mineral density.
时间窗: Day 1
Based on comparison of bone and serum biomarkers in kidney donors and non-donors: (NTX; CTX; TRAcP5b; OC; BAP; P1NP; sclerostin assay); 1,25(OH)2D; 25(OH)D2 and 25(OH)D3; parathyroid hormone (PTH); fibroblast growth factor-23 (FGF23).
Changes in bone health after kidney donation
时间窗: Day 1
As indicated by comparisons between kidney donors and non-donors of dual-energy X-ray absorptiometry (DXA) measurements of bone mineral density at the lumbar spine (L1-L4), total hip and distal 1/3 of the forearm (GE Lunar) by DXA. Will be expressed as a T-score offset from expected peak bone mass as contained in the DXA scanner manufacturers' database.
Incidence of changes in blood counts and blood chemistry measures after kidney donation
时间窗: Day 1
Based on variations between donors and non-donors in measures of complete blood count, serum electrolytes, Ca, Pi, creatinine, blood urea nitrogen and albumin.
Assess the correlations of renal function with bone mineral health.
时间窗: Day 1
Renal function will be assessed by Measured Glomerular Filtration Rate (GFR), using the iothalamate short renal clearance technique, and by 24 hour urine collection to record the measures of creatinine clearance, urinary excretion of calcium, phosphorus, albumin and protein.
次要结局
- Evaluate Advanced Glycation Endproducts (AGEs) correlation to bone health parameters.(Day 1)
- Explore how vertebral Trabecular Bone Score (TBS) correlates with measures of bone health.(Day 1)
研究者
Rajiv Kumar, M.D.
Principal Investigator
Mayo Clinic