Overview

Mineralocorticoid Receptor Antagonist and Kidney Allograft Histology

Status:
Unknown status

Trial end date:
2014-01-01

Target enrollment:
0

Participant gender:
All

Summary

Chronic allograft nephropathy is one of dominant causes of long term kidney transplant failure. Its main histological determinant is interstitial fibrosis and tubular atrophy. Mechanisms of these changes are multifactorial and are not completely elucidated. Epithelial mesenchymal transition (EMT) might be one of the mechanisms. On molecular level role of renin angiotensin aldosterone system (RAAS) has been recognized. Recently, mineralocorticoid hormone aldosterone has been proposed as a possible direct contributor to the progression of renal injury and fibrosis, beside his well known role as a regulator of extracellular fluid volume and sodium and potassium balance. In this study the investigators will determine the impact of mineralocorticoid receptor antagonist use on progression of chronic scores in transplanted kidney over one year. The investigators hypothesis is that spironolactone use in kidney transplant patients will slow down progression of chronic histological changes- interstitial fibrosis, tubular atrophy and arteriolar hyalinosis.

Phase:

Phase 4

Accepts Healthy Volunteers?

Details

Lead Sponsor:

Clinical Hospital Merkur

Treatments:

Mineralocorticoid Receptor Antagonists
Mineralocorticoids
Spironolactone

Criteria

Inclusion Criteria:

- kidney and kidney-pancreas recipients, including patients with delayed graft function
( DGF). DGF will be defined as the dialysis need in first 7 days after transplantation

Exclusion Criteria:

1. Baseline plasma potassium level above 5.1 µmol/L

2. Patients on ACE inhibitor or ARB-s therapy

3. Patients with eGFR < 30 ml/min (estimated by MDRD formula)

4. Patents younger than 18 yr

5. Patients with hypersensitivity to spironolacton