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Trial registered on ANZCTR
Registration number
ACTRN12624001205527
Ethics application status
Approved
Date submitted
9/09/2024
Date registered
1/10/2024
Date last updated
1/10/2024
Date data sharing statement initially provided
1/10/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Detection of Kidney Transplant Medication Toxicity
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Scientific title
Detecting Kidney Transplant Calcineurin Inhibitor Toxicity (the TransTox Study) in adult patients
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Secondary ID [1]
310148
0
None
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Universal Trial Number (UTN)
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Trial acronym
TransTox
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Kidney Transplant
330719
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Condition category
Condition code
Renal and Urogenital
327556
327556
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0
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Kidney disease
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
1
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Target follow-up type
Years
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Description of intervention(s) / exposure
Kidney transplantation and exposure to tacrolimus.
This study involves daily blood and urine sample collection of patients undergoing kidney transplantation, from one day before the transplant up to 30 days after (or earlier, if patient is discharged from the study hospital before postoperative day 30). Medical record information is also gathered, including daily tacrolimus dosage and blood levels, potential episodes of AKI after transplant and causes, such as rejection, infections or surgical complications, kidney biopsy results, long-term kidney function and damage, as measured by serum creatinine and urine albuminuria. The overall duration of observation is from time of enrolment for 12 months.
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Intervention code [1]
326546
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Diagnosis / Prognosis
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
335407
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The primary outcome will be the number of histological alterations potentially related to tacrolimus toxicity (as a continuous measurement) at the 3-month protocolar kidney biopsy. The potential alterations include (1) isometric tubular vacuolation, (2) thrombotic microangiopathy, (3) arteriolar hyalinosis, (4) tubular atrophy, (5) interstitial fibrosis and (6) dystrophic calcification. The primary outcome will be the score represented by the number of the alterations at the 3-m kidney biopsy, from 0 to 6.
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Assessment method [1]
335407
0
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Timepoint [1]
335407
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3-month protocolar kidney biopsy
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Secondary outcome [1]
439546
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AKI determined by the kidney biomarkers urinary KIM-1 AND urinary MCP-1 (composite):
urinary KIM-1 /urinary creatinine (uCr) > 0.1 ng/umol plus urinary MCP-1 /uCr> 0.01ng/umol
(levels based on the upper 95% percentile in studies performed by our group in healthy patients).
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Assessment method [1]
439546
0
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Timepoint [1]
439546
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Daily, within the first 30 days after kidney transplantation.
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Secondary outcome [2]
439979
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AKI determined by the kidney biomarkers urinary KIM-1 AND urinary calbindin (composite):
urinary KIM-1 /urinary creatinine (uCr) > 0.1 ng/umol plus increased biomarker urinary calbindin /uCr> 1.97 ng/umol (levels based on the upper 95% percentile in studies performed by our group in healthy patients).
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Assessment method [2]
439979
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Timepoint [2]
439979
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Daily, within the first 30 days after kidney transplantation.
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Secondary outcome [3]
439980
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AKI determined by the kidney biomarkers urinary KIM-1 AND urinary clusterin (composite):
urinary KIM-1 /urinary creatinine (uCr) > 0.1 ng/umol plus urinary clusterin /uCr>1.02ng/umol (levels based on the upper 95% percentile in studies performed by our group in healthy patients).
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Assessment method [3]
439980
0
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Timepoint [3]
439980
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Daily, within the first 30 days after kidney transplantation.
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Secondary outcome [4]
439981
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AKI determined by the kidney biomarkers urinary KIM-1 AND urinary GSTp (composite):
urinary KIM-1 /urinary creatinine (uCr) > 0.1 ng/umol plus urinary GSTp /uCr> 3.67ng/umol (levels based on the upper 95% percentile in studies performed by our group in healthy patients).
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Assessment method [4]
439981
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Timepoint [4]
439981
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Daily, within the first 30 days after kidney transplantation.
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Secondary outcome [5]
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AKI determined by the kidney biomarkers KIM-1 AND urinary IL-18 (composite):
urinary KIM-1 /urinary creatinine (uCr) > 0.1 ng/umol plus urinary IL-18 /uCr> 0.003ng/umol (levels based on the upper 95% percentile in studies performed by our group in healthy patients).
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Assessment method [5]
439982
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Timepoint [5]
439982
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Daily, within the first 30 days after kidney transplantation.
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Secondary outcome [6]
439983
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The number of histological alterations potentially related to tacrolimus toxicity (as a continuous measurement) at the 12-month protocolar kidney biopsy. The potential alterations include (1) isometric tubular vacuolation, (2) thrombotic microangiopathy, (3) arteriolar hyalinosis, (4) tubular atrophy, (5) interstitial fibrosis and (6) dystrophic calcification. This secondary outcome will be the score represented by the number of the alterations at the 12-m kidney biopsy, from 0 to 6.
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Assessment method [6]
439983
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Timepoint [6]
439983
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At the 12-month protocolar kidney biopsy (12 months after kidney transplantation).
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Secondary outcome [7]
439984
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Long-term kidney function determined by serum creatinine
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Assessment method [7]
439984
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Timepoint [7]
439984
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At 12 months after kidney transplantation
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Eligibility
Key inclusion criteria
Adult patients undergoing kidney transplantation with no prior exposure to tacrolimus.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
age < 18 yo;
non-consent
transplant cancelled
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
16/09/2022
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Date of last participant enrolment
Anticipated
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Actual
30/09/2024
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Date of last data collection
Anticipated
4/12/2025
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Actual
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Sample size
Target
60
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Accrual to date
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Final
66
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
27084
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Prince of Wales Hospital - Randwick
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Recruitment postcode(s) [1]
43156
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2031 - Randwick
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Funding & Sponsors
Funding source category [1]
314310
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Charities/Societies/Foundations
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Name [1]
314310
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Prince of Wales Hospital Foundation
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Address [1]
314310
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Country [1]
314310
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Australia
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Primary sponsor type
Individual
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Name
Professor Zoltan Endre, Nephrology Department at Prince of Wales Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
316257
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Charities/Societies/Foundations
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Name [1]
316257
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Prince of Wales Hospital Foundation
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Address [1]
316257
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Country [1]
316257
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
313420
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South Eastern Sydney Local Health District HREC
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Ethics committee address [1]
313420
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https://www.seslhd.health.nsw.gov.au/services-clinics/directory/research-home/ethics
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Ethics committee country [1]
313420
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Australia
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Date submitted for ethics approval [1]
313420
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06/09/2021
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Approval date [1]
313420
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15/12/2021
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Ethics approval number [1]
313420
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2021/ETH11450
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Summary
Brief summary
This is an observational study to discover and assess new markers in the blood or urine that detect early stages of kidney damage from the toxic effects of transplant anti-rejection medications (tacrolimus). Patients undergoing kidney transplantation with no prior exposure to tacrolimus are enrolled and daily blood and urine samples are collected for the first 30 days after the transplant. The hypothesis is that we can better detect kidney toxicity caused by tacrolimus by using the new biomarkers studied here than by the standard clinical measurement of serum creatinine. This will allow our team to develop better protocols to determine tacrolimus dosage in clinical care within the first 30 days after kidney transplantation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
128098
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Prof Zoltan Endre
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Address
128098
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Prince of Wales Hospital, High Street, Randwick, NSW, 2031 - Nephrology Department, level 3
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Country
128098
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Australia
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Phone
128098
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+61 408 616 776
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Fax
128098
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Email
128098
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[email protected]
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Contact person for public queries
Name
128099
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Prof Zoltan Endre
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Address
128099
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Prince of Wales Hospital, High Street, Randwick, NSW, 2031 - Nephrology Department, level 3
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Country
128099
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Australia
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Phone
128099
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+61 408 616 776
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Fax
128099
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Email
128099
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[email protected]
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Contact person for scientific queries
Name
128100
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Zoltan Endre
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Address
128100
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Prince of Wales Hospital, High Street, Randwick, NSW, 2031 - Nephrology Department, level 3
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Country
128100
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Australia
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Phone
128100
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+61 408 616 776
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Fax
128100
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Email
128100
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All de-identified data.
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When will data be available (start and end dates)?
After study publication, no end date.
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Available to whom?
To the whole scientific community.
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Available for what types of analyses?
Any.
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How or where can data be obtained?
International repositories via website (https://data.csiro.au/)
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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