Validation of New Markers of Glomerular Filtration Rate: Dota Gadolinium and Calcium EDTA (MultiGFR)
- Conditions
- Renal Insufficiency, ChronicKidney Diseases
- Interventions
- Registration Number
- NCT02286258
- Lead Sponsor
- Assistance Publique - Hôpitaux de Paris
- Brief Summary
The purpose of this study is to validate in comparison to a reference method (inuline) two novel non-radioactive biomarkers for glomerular filtration rate (GFR) measurement in chronic-kidney disease (CKD) patients and in healthy volunteers: Calcium-EDTA and Gd-DOTA.
- Detailed Description
Research on estimation and measurement of renal function has been greatly stimulated by the international concept of chronic kidney disease (CKD) and its classification into stages of severity based on the level of glomerular filtration rate (GFR) (National Kidney Foundation KDOQI and ANAES in 2002, KDIGO conference in 2005), and by the development of recommendations for clinical practice according to this stages. Many efforts have focused on the validation of new formula to estimate GFR from endogenous markers. Nevertheless, the performance of these formula is limited by a large inter individual variability, that requires in many cases the use of GFR measurement using exogenous tracers (extreme anthropometric characteristics, abnormal production of endogenous tracers, potential kidney donors, dose adjustment, nephrotoxicity monitoring...). The use of GFR measurement is burdened by a lack of availability due to methodological, biological and regulatory (for radioactive tracers) constraints. That's why a need exists for new validated tracers that will be more accessible and easier to use. Moreover, there are differences between the measurement techniques: single injection of the tracer or concentration equilibrium obtained by continuous infusion; plasma or urinary clearance.
Two new tracers for GFR measurement are here offered for validation: Gd-DOTA and Calcium-EDTA. Gd-DOTA is a macrocyclic paramagnetic contrast product, which can be measured using an ELISA type immunoassay. Although being widely used in radiology with higher doses than those that will be used for GFR measurement in the multi-GFR study, Gd-DOTA has never been involved in systemic nephrogenic fibrosis cases (ProFinest study). Calcium-EDTA has been used for many years for the chelation of heavy metals. Recently, a colorimetric assay for Calcium-EDTA measurement has been developed. Gd-DOTA and Calcium-EDTA clearance for GFR measurement will be compared to inuline clearance in healthy volunteers (25 for each new tracer) and CKD patients (150 for each new tracer).
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 166
- males or females without pregnancy
- age : 18-75
- stable chronic kidney disease stages 1 to 4 (MDRD KDIGO 2005), estimated GFR > 15 mL/min/1.73m²
- clinical GFR measurement indication
- kidney transplantation
- allergic
- acute disease leading to acute change in GFR
- heavy metals poisoning (treated or not)
- gadolinium contrast agent in the previous month
Healthy volunteers :
Inclusion criteria
- males, 18-35 years old
- weight : 60-100 kg , BMI 18-27 kg/m²
- estimated GFR > 90 mL/min/1.73 m² (MDRD)
- acute diseases in the previous 7 days
Exclusion criteria :
- uro-nephrological disease (past or present)
- nephrotoxic drug chronic use in the previous 2 months
- allergic
- systemic disease (acute or chronic)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Inuline - Calcium EDTA Calcium EDTA Calcium EDTA clearance for GFR measurement is compared to inuline clearance in healthy volunteers and CKD patients (stage 1 to 4). Inuline - Gd-DOTA Gd-DOTA Gd-DOTA clearance for GFR measurement is compared to inuline clearance in healthy volunteers and CKD patients (stage 1 to 4).
- Primary Outcome Measures
Name Time Method Calcium EDTA and Gd-DOTA clearance for glomerular filtration rate measurement 1 day Calcium EDTA or Gd-DOTA clearance for GFR measurement is compared to inuline clearance in healthy volunteers (n= 25) and in CKD patients (n= 150, stages 1 to 4, 30 patients for each stage) at equilibrium by measuring urinary clearances of inuline and Calcium EDTA or Gd-DOTA continuously co-infused after a loading dose.
- Secondary Outcome Measures
Name Time Method Volumes of distribution of Calcium EDTA and Gd-DOTA 1 day Calcium EDTA or Gd-DOTA apparent volumes of distribution are compared to inuline apparent volume of distribution in healthy volunteers (n= 25) and in CKD patients (n= 150, stages 1 to 4, 30 patients for each stage).
Calcium EDTA and Gd-DOTA clearance for glomerular filtration rate measurement in each CKD stage 1 day Calcium EDTA or Gd-DOTA clearance for GFR measurement is compared to inuline clearance in healthy volunteers (n= 25) and in CKD patients (n= 150, stages 1 to 4, 30 patients for each stage) at equilibrium by measuring urinary clearances of inuline and Calcium EDTA or Gd-DOTA continuously co-infused after a loading dose.
Calcium EDTA and Gd-DOTA clearance with single injection for GFR measurement 15 days Calcium EDTA or Gd-DOTA clearance is measured twice at day 1 and day 15 in healthy volunteers (n= 25) and in CKD patients (n= 25, stages 1 to 4, 5 patients for each stage) at equilibrium at day 1 by measuring urinary clearances of inuline and Calcium EDTA or Gd-DOTA continuously co-infused after a loading dose and at day 15 with a single loading dose of Calcium EDTA or Gd-DOTA
Calcium EDTA and Gd-DOTA clearance reproducibility for GFR measurement 15 days Calcium EDTA or Gd-DOTA clearance is measured twice at day 1 and day 15 in healthy volunteers (n= 25) and in CKD patients (n= 25, stages 1 to 4, 5 patients for each stage) at equilibrium by measuring urinary clearances of inuline and Calcium EDTA or Gd-DOTA continuously co-infused after a loading dose.
Number of participants with adverse events as a measure of safety. 45 days Each event following Calcium EDTA or Gd-DOTA infusion will be listed in healthy volunteers (n = 50) and in patients (n = 300).
Trial Locations
- Locations (4)
Hopital Europeen Georges Pompidou (centre d'investigations cliniques)
🇫🇷Paris, France
Hopital Europeen Georges Pompidou (Service de Nephrologie)
🇫🇷Paris, France
Hopital Europeen Georges Pompidou (service de Physiologie et des Radioisotopes)
🇫🇷Paris, France
CHU Rangueil (service explorations fonctionnelles physiologiques)
🇫🇷Toulouse, France