Kidney Neoplasms Clinical Trial
Official title:
Dynamic Measurement of Renal Functional Reserve as a Predictor of Long-Term Renal Function
The number of people with kidney disease is constantly rising and renal failure represents
one of the major health care burdens globally. An accurate measurement of kidney function is
urgently needed to better understand and treat loss of renal function. Kidneys have an
intrinsic reserve capacity to respond to a higher work load by increasing filtration in their
nephrons. The number of nephrons and their reserve capacity define how well kidneys can adapt
to an increased demand and disease.
The degree of renal reserve capacity becomes particularly important when the number of
functioning nephrons is significantly reduced either due to surgical removal of one kidney as
in living kidney donation or in tumor nephrectomy or due to progressive injury as in
autosomal dominant polycystic kidney disease (ADPKD). A reduced functional reserve likely
reflects an impaired adaptive capacity and increased risk of accelerated loss of function in
the remaining single kidney or in kidneys exposed to a disease. Despite the importance of
accurately measuring baseline and reserve capacity renal function, due to the time- and
laborintensive procedure, in clinical routine this testing is rarely done.
Investigators aim to measure renal functional reserve (RFR) and loss of function in patients
undergoing nephrectomy (living kidney donors and renal tumor patients) as well as in patients
with ADPKD.
The results should provide evidence whether renal functional reserve indeed predicts adaptive
capacity and functional loss after removal of a healthy kidney (living donors), of a tumor
kidney (cancer patients) or in progressive kidney disorders (ADPKD patients).
Investigators are confident that the proposed project will enhance the understanding of
progressive kidney disease and with this improve donor safety, planning of tumor nephrectomy,
and prediction of renal functional loss as well as provide a strong argument that dynamic
renal function testing, i.e. accurate measurement of baseline and reserve capacity, is
necessary in certain disease entities.
The measurement of RFR will be performed by dynamic testing of the changes in baseline glomerular filtration rate (GFR) induced by an oral protein load. Sinistrin (a polyfructosan with identical clearance characteristics to inulin) will be used to measure GFR. ;
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