Fabry Disease Clinical Trial
Official title:
Fabry Disease: Renal Function During Long-term Enzyme Replacement Therapy Evaluated by Gold Standard GFR 51Cr-EDTA Clearance
The aim of this study was to investigate renal function decline by measured glomerular filtration rate (mGFR) in patients with FD during enzyme replacement therapy, and to explore the influence of age on renal function in FD.
Nephropathy is common in Fabry disease (FD). Renal function decline is often the first sign
of major organ involvement, sometimes progressing to end-stage renal failure. Available
studies of renal function during enzyme replacement therapy have shown inconsistent results,
and are based on different composition of patient materials and follow-up time.
Most investigations have used estimated glomerular filtration rate (eGFR) for evaluating
renal function. GFR is an important indicator of renal function. eGFR based on a serum
creatinine measurement is most commonly used in FD. However, this method has been shown to be
unreliable, as serum creatinine levels are influenced by other factors than renal function
such as ethnic group, muscle mass, age, hydration and diet. Performance of eGFR in detecting
minor changes in renal function is poor. A 10 year old review on renal function evaluation in
patients with FD recommended the use of GFR based on an exogenous marker, e.g. Cr-EDTA.
Nevertheless, only few studies have used mGFR for evaluation of renal function and to our
knowledge, the present study is the first to describe the rate of renal function decline with
consecutive mGFR values in a nationwide population of patients with FD.
Renal function declines with age in renal healthy individuals. To our knowledge, the present
study is the first to age-standardize renal function in patients with FD to adjust for
age-dependent renal deterioration.
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