Characterization of the Nrf2 Response in Patients With Autosomal Dominant Polycystic Kidney Disease (ADPKD)
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Autosomal Dominant Polycystic Kidney Disease. Basic parameters: 18 years — 30 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The purpose of this study is to characterize oxidative stress and the Nrf2 antioxidant response in early stages of Autosomal Dominant Polycystic Kidney Disease (ADPKD), while identifying candidate biomarkers.
Detailed description
Intracellular Reactive Oxygen Species (ROS) concentration is a major determinant of cellular fate and is finely regulated by the cell's antioxidant systems. While low levels of ROS are required for pro-survival signaling, cell proliferation, growth, and energy metabolism, the excess of ROS or oxidative stress leads to inflammation, cell death, and disease/injury progression. Indeed, oxidative stress is commonly observed in several renal diseases including ADPKD. On the other hand, a surplus of antioxidants will not only neutralize ROS, but may result in the antithesis of oxidative stress, which is known as reductive stress. The Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is a transcription factor that integrates cellular stress signals and responds by regulating the expression of several antioxidant proteins. Activation of the Nrf2-mediated antioxidant defense pathway enhances ROS detoxification, conferring a more reduced intracellular environment that can promote cell survival and proliferation, a distinctive feature in ADPKD that underlies cyst formation and enlargement. Therefore, a better characterization of ROS levels and antioxidant response in ADPKD patients would allow development of more specific and effective therapies, while providing additional related biomarkers.
The investigators broad objective is to characterize oxidative stress and the Nrf2 antioxidant response in early stages of ADPKD, while identifying candidate biomarkers.
Participants in this study will have a blood and a urine sample collected to determine biomarkers of oxidative status and antioxidant response to study redox balance at early stages of the disease. In addition, an abdominal MRI will be performed to determine patient's total kidney volume (TKV).
Primary outcome measures
- Assessment of Oxidative Status [Time frame: Baseline]
- Assessment of Antioxidant Response [Time frame: Baseline]
- Total kidney volume (TKV) [Time frame: Baseline]
Secondary outcome measures (1)
- Assessment of Kidney Injury [Time frame: Baseline]
Eligibility criteria
Inclusion Criteria (ADPKD Subjects):
- ADPKD (based on Ravine et al. criteria)
- Class 1 B-E according to our imaging classification
- Male and female subjects 18 - 30 years of age, inclusive
- Estimated GFR> 60 mL/min/m2 (CKD-EPI equation)
- Ability to provide written, informed consent.
Exclusion Criteria (ADPKD Subjects):
- Class 2 according to our imaging classification
- Concomitant systemic disease in the kidney (e.g. lupus, hepatitis B or C, amyloidosis)
- Diabetes mellitus (fasting glucose > 126 mg/dL or treatment with insulin or oral hypoglycemics).
- Predicted urine protein excretion in urinalysis >1 g/24 hrs
- Abnormal urinalysis suggestive of concomitant glomerular disease.
- Subjects having contraindications to, or interference with MRI assessments. \[For example: ferromagnetic metal prostheses, aneurysm clips, severe claustrophobia, large abdominal/back tattoos, etc\].
- Female subjects that are pregnant
Inclusion Criteria (Healthy Subjects):
- Male and female subjects 18 - 30 years of age, inclusive
- Estimated GFR> 60 mL/min/m2 (CKD-EPI equation)
- Ability to provide written, informed consent.
Exclusion Criteria (Healthy Subjects):
- Previous personal or family history of kidney disease.
- Concomitant systemic disease in the kidney (e.g. lupus, hepatitis B or C, amyloidosis)
- Diabetes mellitus (fasting glucose > 126 mg/dL or treatment with insulin or oral hypoglycemics).
- Presence of proteinuria
- Abnormal urinalysis suggestive glomerular disease.
- Subjects having contraindications to, or interference with MRI assessments. \[For example: ferromagnetic metal prostheses, aneurysm clips, severe claustrophobia, large abdominal/back tattoos, etc\]
- Female subjects that are pregnant
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Observational model
- Case-control
Study locations
United States · 1 center
- Mayo Clinic in Rochester — Rochester
Identifiers
NCT: NCT04344769 · 17-008806 · R21DK118391