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The overall goals of this study are to demonstrate the change in renal tubular function in living donors pre and post nephrectomy at 6 months.
The physiologic sequelae of living kidney donation are still poorly understood. Uni-nephrectomy from donation results in decreased number of glomeruli and research has shown that there is glomerular hyperfiltration and glomerular hypertrophy. Uni-nephrectomy also results in a decreased number of tubules, but there is not much data about possible tubular injury post donation and its long term effects on donors.
Our overall hypothesis is that post uni-nephrectomy tubular function, measured by maximum urine concentration capacity, will be decreased and may be a more sensitive marker of kidney damage than standard tests, such as urine albumin, serum creatinine, estimated glomerular filtration rate (eGFR), or measured urine creatinine clearance (CrCl). The goal of this study is to evaluate the effect of uni-nephrectomy on renal tubular function and its potential in being an early and more sensitive marker in kidney injury when compared to standard tests.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Desmopressin | Experimental | All ten subjects will be evaluated pre and post nephrectomy at 6 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Desmopressin | Drug | Subjects will complete a water deprivation test using desmopressin to aid in the determination of maximum tubular concentration capacity before and six months after uni-nephrectomy. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage change in tubular function (urine osmolality measured in MOSMOL/K) pre and post nephrectomy as assessed through water deprivation and administration of desmopressin. | Tubular function is measured as maximal urine concentrating capacity reached after water deprivation and administration of desmopressin. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of serum creatinine when compared to change in tubular function, pre and post nephrectomy as measured in MG/DL. | To test correlations between biomarkers all variables will be log-normalized and Pearson's regression analysis will be used | 6 months |
| Sensitivity of urine albumin excretion when compared to change in tubular function, pre and post nephrectomy as measured in MCG/ML. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pooja Budhiraja, MD | University of Kansas Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Kansas Medical Center | Kansas City | Kansas | 66160 | United States |
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| ID | Term |
|---|---|
| D003894 | Deamino Arginine Vasopressin |
| ID | Term |
|---|---|
| D001127 | Arginine Vasopressin |
| D014667 | Vasopressins |
| D010909 | Pituitary Hormones, Posterior |
| D010907 | Pituitary Hormones |
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To test correlations between biomarkers all variables will be log-normalized and Pearson's regression analysis will be used |
| 6 months |
| Sensitivity of eGFR when compared to change in tubular function, pre and post nephrectomy as measured in mL/min. | To test correlations between biomarkers all variables will be log-normalized and Pearson's regression analysis will be used | 6 months |
| D036361 |
| Peptide Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D009479 | Neuropeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D009842 | Oligopeptides |
| D009419 | Nerve Tissue Proteins |
| D011506 | Proteins |