MedPath

Effect of 3g Versus 2 g MMF in Combination With Tacrolimus on Progression of Renal Allograft Interstitial Fibrosis

Phase 4
Completed
Conditions
Kidney Transplantation
Kidney Failure
Interventions
Registration Number
NCT01860183
Lead Sponsor
Clinical Hospital Merkur
Brief Summary

Development of chronic changes (scarring) in transplanted kidney tissue is a major cause of long-term kidney function deterioration and ultimately graft loss. It results from both immunologic and non-immunologic mechanisms. Mycophenolate mofetil (MMF) is immunosuppressive drug used for prevention of rejection after kidney transplant, usually in combination with a calcineurin inhibitor (tacrolimus or cyclosporine), with or without corticosteroids. Besides immunosuppression, MMF may also have direct antifibrotic properties. Tacrolimus has potent immunosuppressive effects and is the cornerstone of contemporary posttransplant immunosuppressive therapy in kidney recipients. However, it is also nephrotoxic. The hypothesis of the present study is that in the setting of similar net immunosuppression, higher dose of MMF (3 g daily) will result in slower progression of kidney fibrosis during first year posttransplant as compared to MMF 2 g daily. To test this hypothesis, the present study will randomly assign low immunological risk kidney transplant recipients to either 2g or 3 g MMF daily, in combination with tacrolimus, with, or without maintenance steroids. All patients will have kidney biopsy at implantation and at 12 months after transplantation. Main outcome will be 1-year change in chronic kidney histology (interstitial fibrosis) assessed by protocol biopsy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
76
Inclusion Criteria
  1. first kidney or kidney-pancreas transplantation
  2. CDC PRA <=20%
Exclusion Criteria
  1. dual kidney transplantation
  2. AB0 incompatible transplantation
  3. 0 biopsy ci, ct, cv, or ah score >=2

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MMF 3g dailyMycophenolate mofetil-
MMF 2 g dailyMycophenolate mofetil-
Primary Outcome Measures
NameTimeMethod
Progression of interstitial fibrosis (ci)1 year
Secondary Outcome Measures
NameTimeMethod
Estimated glomerular filtration rate1 year
Time to first acute rejection episodeup to 1 year
Progression of other chronic scores1 year
Graft loss1 year
Patient survival1 year

Trial Locations

Locations (1)

Clinical Hospital Merkur

🇭🇷

Zagreb, HR, Croatia

© Copyright 2025. All Rights Reserved by MedPath