Remission Clinic in Proteinuric Chronic Nephropathies
Status:
Active, not recruiting
Trial end date:
2021-11-01
Target enrollment:
Participant gender:
Summary
Most chronic kidney diseases have a progressive evolution characterized by the gradual loss
of glomerular filtration rate (GFR), electrolytic imbalance, reduced erythropoietin synthesis
and activation of vitamin D. On many occasions, the progressive deterioration of renal
function occurs, even when the etiologic factors responsible for the kidney disease are
treated and/or eliminated as a result of an auto-sustained mechanism of inflammation and
fibrosis. Moreover, chronic nephropathies are often associated with high blood pressure and
increased urine protein excretion, being both risk factors of progression toward kidney
failure. Many clinical studies have shown the efficacy of antihypertensive therapies,
particularly the blockade of renin-angiotensin system, to lower the abnormal urinary protein
excretion. Moreover, control of blood pressure and proteinuria slow the rate of renal
function decline and in some cases even lead to recovery of kidney function avoiding the need
for renal replacement therapies. The set of measures to achieve these results encompasses the
term of "renoprotective therapy". However these achievements have been obtained in the
setting of clinical trials, and need confirmation in the daily clinical practice.
To this purpose a standardized multidrug intervention model that aims at normalizing the
excretion of urinary proteins and stabilizing the renal function has been developed for the
outpatient-clinic and named "Remission Clinic".
The applicability of this protocol is aimed for all nephrology and diabetology centers.
Through the use of a dedicated database computer network, it will be possible to share
clinical, laboratory and treatment data, recorded for each patient enrolled in the Remission
Clinic program. With this system, it will be possible to verify if the multidrug approach of
the Remission Clinic will allow to improve the clinical course of chronic proteinuric
nephropathy. All participants (centers) may access to the Remission Clinic website developed,
updated and maintained by the Department of Bioengineering of the Mario Negri Institute,
Bergamo, Italy.
Details
Lead Sponsor:
Mario Negri Institute for Pharmacological Research