Glomerulosclerosis, Focal Segmental, Idiopathic Nephrotic Syndrome, Minimal Change Disease
Conditions
Keywords
Focal and Segmental Glomerulosclerosis, Focal & Segmental Glomerulosclerosis, FSGS, Minimal change disease, MCD, Nephrotic Syndrome
Brief summary
In a monocentric, later multicentric prospective approach the FOrMe registry (The German Focal Segmental Glomerulosclerosis and Minimal Change Disease Registry) aims to generate a longitudinal cohort of 150 pediatric cases of idiopathic nephrotic syndrome and 350 adult cases of biopsy-proven Minimal Change Disease (MCD) or Focal and Segmental Glomerular Sclerosis (FSGS) over 10 years. The registry will provide a repository for biomaterials such as blood samples, DNA, urine, feces, and tissue biopsies that will be accessible to collaborators to facilitate future research on pathogenesis, diagnostics, and treatment.
Detailed description
Idiopathic Nephrotic Syndrome is characterized by proteinuria, volume retention, hyperlipidemia, hypoalbuminemia. As Minimal Change Disease (MCD) represents by far the most prevalent underlying diagnosis in children older than 1 year, a kidney biopsy is usually deferred in these cases. In adolescence and adults, a kidney biopsy is crucial for the diagnosis because MCD and FSGS account for only 10-15 and 12-35 percent of all cases of nephrotic syndrome respectively. Pathomechanisms as well as optimal treatment remain elusive as systematic trials are scarce and hampered by low incidence and heterogenicity of the clinical presentation. To bridge this informational gap, the investigators identified the need for a German registry of pediatric and adult patients with idiopathic nephrotic syndrome (in children) and biopsy-proven MCD/FSGS (in adults). The registry will record clinical data of participants regarding basic demographics, initial presentation, hereditary traits, disease course and treatment modalities as well as quality of life, concomitant diseases, and comedication. During the initial visit and to a lesser intent on follow-up visits, biomaterials (blood, urine, DNA, feces, tissue) will be collected and stored in a state-of-the art biobank. This material will be available to collaborators to support research on idiopathic nephrotic syndrome and MCD/FSGS. By the time of completion, the registry will provide data on clinical courses and outcome of approximately 500 patients that can easily be correlated with biomaterials giving insight into risk factors, prognostic parameters, and association with comorbidities. Tissue sections of all patients that undergo kidney biopsy (all adult and some pediatric patients) will be digitalized, annotated, and analyzed by a panel of nephropathologists. Histopathologic features will be individually assessed and scored according to a set of descriptors that was developed and is used by the American NEPTUNE (Nephrotic Syndrome Study Network).
Interventions
OTHERBiosampling
Biosampling at initial visit and follow-up visits
Sponsors
German Research Foundation
Medical Faculty and the Faculty of Natural Sciences of the University of Cologne
Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases
Cologne Center for Genomics
Prof. Dr. Paul Brinkkoetter
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
(cohort A): * written informed consent * 17 or less years of age * idiopathic nephrotic syndrome Inclusion Criteria (cohort B): * written informed consent * older or equal to 18 years of age * biopsy-proven primary or secondary FSGS or MCD or biopsy-proven recurrence of disease in kidney transplant.
Exclusion criteria
(both cohorts): * Prior kidney transplant without biopsy-proven recurrence * A clinical diagnosis of other glomerular disease resulting in secondary MCD or FSGS as judged by the treating physicians. * Refusal to provide written informed consent * (Anticipated) incompliance with visit schedule
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Average Annual Change in estimated glomerular filtration rate (eGFR) | 5-15 years | Outcome measure: eGFR loss in ml/min/year. Higher values are considered worse outcome. |
| Incidence of End-stage Renal Disease (ESRD) | 5-15 years | Documented initiation of chronic renal replacement therapy regardless of type. |
| Incidence of Death | 5-15 years | Documented patient death due to any cause |
| Incidence of Kidney Transplantation | 5-15 years | Documented kidney transplantation regardless of type (living donor, cadaveric donor) |
| Changes in Quality of Life (adults patients) | 5-15 years | Patient-reported outcome will be assessed using Quality of Life questionnaires at regular intervals using the SF-36 questionnaire. For reference see https://www.rand.org/health-care/surveys\_tools/mos/36-item-short-form/scoring.html The SF-36 questionnaire measures eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. All items are scored so that a high score defines a more favorable health state. Lowest and highest possible scores are 0 and 100. Scores represent the percentage of total possible score achieved. Original publication: Ware, J.E., Jr., & Sherbourne, C.D. The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection,. Medical Care, 30:473-483, 1992. |
| Changes in Quality of Life (pediatric patients) | 5-15 years | Patient-reported outcome will be assessed using Quality of Life questionnaires at regular intervals using the PedsQL questionnaire. For reference see https://www.pedsql.org/score.html The PedSQL questionnaire measures four health concepts: Physical Functioning, Emotional Functioning, Social Functioning, and School Functioning. Items are reversed scored and linearly transformed to a 0-100 scale, so that higher scores indicate better HRQOL (Health-Related Quality of Life). To create Scale Scores, the mean is computed as the sum of the items over the number of items answered (this accounts for missing data). To create the Total Scale Score, the mean is computed as the sum of all the items over the number of items answered on all the Scales. |
Countries
Germany
Contacts
Primary ContactPaul T Brinkkoetter, MD
Backup ContactLinus A Voelker, MD
Outcome results
None listed