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Eplerenone in Patients Undergoing REnal Transplant (EPURE TRANSPLANT)

Phase 3
Active, not recruiting
Conditions
End-stage Renal Disease
Interventions
Drug: Placebo
Registration Number
NCT02490904
Lead Sponsor
Central Hospital, Nancy, France
Brief Summary

Assess the impact of eplerenone (initiated within 2 hours prior to patient departure to the operating room and administered for 4 days during the post-operative period) on graft function evaluated by the measurement of glomerular filtration rate at 3 months - variable strongly associated with long-term graft survival.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
132
Inclusion Criteria
  • Patients older than 18 years of age
  • Informed consent
  • Candidate for a single or a dual kidney transplantation from an expanded criteria deceased donor ( 60 years or older or age between 50 and 59 with 2 of the 3 following criteria: cardiovascular death, history of hypertension, serum creatinine above 130µmol/L), regardless of machine perfusion and graft rank
  • Chronic hemodialysis
  • Affiliated to a social security system
Exclusion Criteria
  • Multiple organ transplantation (kidney and liver, kidney and heart, kidney and pancreas, kidney and lung, kidney and intestine)
  • Patient receiving a graft from a donor under mineralocorticoid receptor antagonist treatment (spironolactone or eplerenone)
  • Peritoneal dialysis
  • Preemptive transplantation
  • Hypersensitivity or known allergy to Eplerenone or one of its excipients
  • Patients with severe hepatic insufficiency (class Child-Pugh C)
  • Patient receiving powerful CYP3A4 inhibitors (for example itraconazole, ketoconazole, ritonavir, nelfinavir, clarithromycin, telithromycyn and nefazodone)
  • Hypersensitivity or known allergy to iodinated contrast agents (iohexol)
  • Demonstrated thyrotoxicosis
  • Hypersensitivity to lactose
  • HLA desensitization prior to renal transplantation
  • Pregnant woman or woman without effective contraception
  • Patient under judicial protection
  • Patient under legal guardianship
  • Participation in another biomedical study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo groupPlaceboPlacebo administration within 2 hours prior to patient departure to the operatingroom and for 4 days after kidney transplantation
Eplerenone groupEplerenoneEplerenone administration within 2 hours prior to patient departure to the operating room and for 4 days after kidney transplantation.
Primary Outcome Measures
NameTimeMethod
Iohexol clearance3 months

Graft function at 3 months evaluated by GFR using iohexol clearance

Secondary Outcome Measures
NameTimeMethod
24-hour microalbuminuria3 months
Length of initial hospital stay1 month

between transplantation and discharge

Proportion of patients with biopsy-proven acute rejection3 months post transplant

Proportion of patients with biopsy-proven acute rejection in the first three month after transplantation

glomerular filtration rate3 months 1 year, 3 years, 10 years

estimation using the CKD-EPI formula (in mL/min/1.73m2)

Proportion of patients presenting a delayed graft function7 days post transplantation

The proportion of patients with a delayed graft function defined by the need for one or more dialysis sessions during the 7 days following transplantation

24-hour proteinuria3 months
Occurrence of hyperkalemia > 6 mmol/l7 days post transplant
Proportion of patients alive3 months 1 year, 3 years, 10 years

vital status collected through the national database of organ recipients

Proportion of patients with immediate renal recovery,7 days post transplant

The proportion of patients with an immediate renal recovery is defined by a serum creatinine lower than 30 mg/L at 7 days post-transplant

Proportion of dialysis dependency3 months
serum creatinine3 months 1 year, 3 years, 10 years

using the enzymatic method

Iohexol clearance < 30 mL/min/1,73m²3 months
Proportion of patients with a slow renal recovery7 days post transplant

The proportion of patients with slow renal recovery is defined by serum creatinine above 30 mg/L at 7 days post-transplant without the need for dialysis

Trial Locations

Locations (7)

CHU Dijon- Hôpital Bocage Central

🇫🇷

Dijon, France

CHRU Besançon

🇫🇷

Besancon, France

CHU Brest

🇫🇷

Brest, France

CHRU de Nancy

🇫🇷

Nancy, France

CHU Reims-Hôpital Maison Blanche

🇫🇷

Reims, France

CHU Saint Etienne

🇫🇷

Saint-Étienne, France

NHC -CHRU Strasbourg

🇫🇷

Strasbourg, France

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