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Report for Clinical Trial NCT03136562

Developed by Shray Alag, 2020.
SNP Clinical Trial Gene

Prevalence of Adrenal Insufficiency in Kidney Transplanted Patients (NTx) in Glucocorticoid Treatment

The primary purpose of this study is to determine the prevalence of adrenal insufficiency in a population of patients with kidney transplants receiving low dose prednisone treatment. Development of glucocorticoid-induced adrenal insufficiency is a serious adverse effect to glucocorticoid treatment. The study includes a control group of patients with kidney failure currently treated in dialysis, who are not in glucocorticoid treatment. Individual genotyping is performed to determine the haplotype of glucocorticoid receptor polymorphisms: N363 S, BclI, ER23/23EK and 9β in all the patients with the purpose of investigating this as a risk factor for the development of adrenal insufficiency. The hypothesis is that subjects with one or another of the polymorphisms in the glucocorticoid receptor gene will either have increased or diminished glucocorticoid sensitivity. Using validated questionnaires assessing the quality of life and functional level of the patients enrolled in the study we aim to establish a link between functional level and biochemically proven adrenal insufficiency. Other secondary outcomes in the study includes bloodpressure, body composition, bone density, metabolic syndrome, inflammation and salivary cortisol profiles.

NCT03136562 Adrenal Insufficiency
MeSH:Adrenal Insufficiency
HPO:Adrenal insufficiency

1 Interventions

Name: Synacthen test

Description: 250 microg synacthen test performed fasting, in the morning. P-cortisol measured before and 30 minutes after Synacthen injection.
Type: Diagnostic Test
Group Labels: 2

Control group Kidney transplanted patients


Primary Outcomes

Description: Cutoff for normal adrenal function: 30 min p-cortisol >/= 420 nmol/L.

Measure: The primary outcome measure of this study is the result of the Synacthen® test using primarily the level of P-cortisol 30 minutes after the injection of synacthen.

Time: The time frame of each Synacthen® test is approximately 90 minutes.

Secondary Outcomes

Description: History of treatment with prednisone and other types of glucocorticoids to examine dosage and time of treatment as risk factors.

Measure: Registration of history of treatment.

Time: The registration will take place at the study visit (approximately 90 minutes).

Description: Assessed in all patients enrolled in the study using validated questionnaires as a means to establish a link between functional level and biochemically proven adrenal insufficiency.

Measure: Quality of life and functional level.

Time: Patients receive and fill out the questionnaires prior to their arrival at the study visit and hand them in after the Synacthen® test. Patients receive questionnaires either by mail or at one of their visits in the out patient clinic.

Description: Patients are genotyped for 4 polymorphisms (9 beta, ER22/23EK, Bcl1 and N363S) of the glucocorticoid receptor.

Measure: Determination of the specific type of glucocorticoid receptor using genotyping in all the patients with the purpose of investigating this as a risk factor for the development of adrenal insufficiency.

Time: Blood for genotyping is sampled from each patient at the study visit during the Synacthen® test. The blood samples are stored frozen and analyzed concurrently.

Description: Height, weight, waist and hip circumference.

Measure: Body composition

Time: After the Synacthen® test the height, weight, waist and hip circumference are measured at the study visit.

Description: Results from Dxa-scan.

Measure: Bone density.

Time: The results from latest Dxa-scan performed in rutine settings are collected from the patients on the same day as the Synacthen® test.

Description: Waistline, triglyceride level, HDL cholesterol level, blood pressure and fasting blood sugar is assessed in all the patients.

Measure: Metabolic syndrome.

Time: The waistline and blood pressure are measured at the study visit after the Synacthen® test. The blood samples are collected as part of the test and analyazed on the same day.

Description: Cortisol concentration in saliva.

Measure: Salivary cortisol profiles.

Time: Saliva is sampled from each patient at the study visit as part of the Synacthen® test. The samples are stored frozen and analyzed concurrently after all 60 Synacthen® tests have been performed.

Time Perspective: Cross-Sectional

Cohort


There is one SNP

SNPs


1 N363S

The primary outcome measure of this study is the result of the Synacthen® test using primarily the level of P-cortisol 30 minutes after the injection of synacthen.. Cutoff for normal adrenal function: 30 min p-cortisol >/= 420 nmol/L.. Registration of history of treatment.. History of treatment with prednisone and other types of glucocorticoids to examine dosage and time of treatment as risk factors.. Quality of life and functional level.. Assessed in all patients enrolled in the study using validated questionnaires as a means to establish a link between functional level and biochemically proven adrenal insufficiency.. Determination of the specific type of glucocorticoid receptor using genotyping in all the patients with the purpose of investigating this as a risk factor for the development of adrenal insufficiency.. Patients are genotyped for 4 polymorphisms (9 beta, ER22/23EK, Bcl1 and N363S) of the glucocorticoid receptor.. Body composition. --- N363S ---



HPO Nodes


HPO: