Kidney Diseases Clinical Trial
Official title:
Multicenter, Open-Label, Randomized Study on Steroid-Free Immunosuppression, in Comparison With Daily Steroid Therapy, in Pediatric Renal Transplant : Impact on Growth, Bone Metabolism and Acute Rejection
The present study investigates the safety and efficacy of steroid withdrawal at six days
post-transplant in pediatric renal recipients under concomitant immunosuppression based on
antibodies anti IL2 (interleukin 2), Tacrolimus (TAC) and Mycophenolate Mofetil (MMF). To
investigate the impact of this protocol in growth, bone metabolism, insulin- sensitivity and
evaluate the expression of IL17 (interleukin 17) and mRNA FOXP3 (messenger ribonucleic acid
forkhead box protein 3) as early markers of acute rejection (blood, urine and renal biopsy).
Hypothesis:Steroid withdrawal in renal pediatric transplant patients improves growth and
bone metabolism without increasing the risk of acute rejection. The expression of FoxP3/IL17
in urine cells could be an early molecular markers of acute rejection.
The intention of this investigation is to evaluate a prospective immunosuppressive protocol
based on antibodies anti IL-2 (Ac-IL-2), Tacrolimus (TAC) and Mycophenolate Mofetil (MMF)and
withdrawal steroids in renal transplant and to compare with a steroid-based protocol.
Objectives:
1. To evaluate growth and the impairment in the GH/IGF (growth hormone/insulin like growth
factor) axis
2. To determine the impact of steroids on bone metabolism (biochemical parameters, DXA and
pQCT)
3. To determine the steroid effect on metabolic factors (dyslipidemia, insulin-
sensitivity and arterial hypertension)
4. To determine acute rejection incidence (protocol renal biopsy)
5. To evaluate the expression of IL-17 and mRNA FoxP3 as early markers of acute rejection
(blood, urine and renal biopsy).
Two treatment regimes (Arms)will be compared in randomized form in the course of 12 months
after transplantation.
Arm A: TAC + MMF + withdrawal of steroids over a six-days following randomization.
Arm B: TAC + MMF + prednisolone (see schedule)/day
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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