Major Activation Of NCC in Graft Urinary Exosomes (MANGUE)

University Hospital of Bordeaux

Status: Completed

Conditions: Kidney Transplantation

Treatments: Other: exosomes analysis

Study type: Observational

Funder types: Other

Identifiers

NCT03503461

CHUBX 2018/08

Details and patient eligibility

About

Hypertension is common disorder after renal transplantation and is associated with mortality. Calcineurin Inhibitor (CNI), by activating NCC cotransporter, may be a major determinant of hypertension, included in a "Gordon like" syndrome. However, prevalence of NCC activation by CNI is unknown. Our objective is to determine the prevalence of NCC activation three months after transplantation in patient treated by CNI.

Full description

Hypertension is common disorder after renal transplantation and is associated with mortality. Calcineurin Inhibitor (CNI), by activating NCC cotransporter, may be a major determinant of hypertension, included in a "Gordon like" syndrome. Gordon syndrome is a rare genetic disorder where NCC cotransporter is overactivated and cause hypertension, metabolic acidosis and tendency to hyperkaliemia. Few studies evaluated NCC expression by exosomes techniques in human kidney transplant, and mostly compared NCC expression in specific subpopulation (for example with or without hypertension). Thus, prevalence of NCC activation by CNI is unknown. To determine it, we will include prospective patients in Bordeaux and la Réunion who undergo urine and blood tests three months after transplantation, and a control group with no transplantation and no use of CNI. First, we will compare kidney recipients and control and use immunoblot to quantify NCC expression in urinary exosomes to identify the population of transplanted with a high activation. Then, we will analyze the relationship between NCC activation and clinicobiological features of Gordon's syndrome.

Enrollment: 67 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

For kidney transplant group :

• inclusion criteria:

  • Age≥18years
  • Recipients three months after kidney transplantation using calcineurin inhibitors
  • Glomerular Filtration Rate>15ml.mn.m2 CKD-EPI
  • Renal ultrasound underwent before inclusion
  • No opposition at participating at the research

• exclusion criteria:

  • Use of diuretic thiazides or aldosterone receptor antagonists in the month preceding inclusion
  • Graft artery stenosis with indication of interventional radiology or surgery

For control group :

• Inclusion criteria

  • No previous transplantation
  • Age≥18years
  • No hypertension
  • No metabolic disorders (dysnatremia, dyskaliemia, acidosis or alkalosis)
  • No opposition at participating at the research

• Exclusion criteria:

  • Use of diuretic thiazides or aldosterone receptor antagonists in the month preceding inclusion

Trial design

67 participants in 2 patient groups

Control group

Description:

Control group is a population of subjects admitted to day hospitalization for renal function tests or in conventional hospitalization, but without kidney transplant. Exosome analysis will be perform in urine sample.

Treatment:

Other: exosomes analysis

Kidney transplants group

Description:

Kidney transplants group is a kidney transplant subjects population 3 months ago. Exosome analysis will be perform in urine sample collected at 3 months.

Treatment:

Other: exosomes analysis