Urinary biomarkers of aminoglycoside-induced nephrotoxicity in children with cystic fibrosis
| ISRCTN | ISRCTN43716844 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN43716844 |
| Secondary identifying numbers | 11815 |
- Submission date
- 06/03/2012
- Registration date
- 08/05/2012
- Last edited
- 21/01/2019
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Nutritional, Metabolic, Endocrine
Plain English summary of protocol
Background and study aims
Children with the genetic disease cystic fibrosis (CF) are prone to chest infection with a bacterium called Pseudomonas aeruginosa. Treatment with a type of antibiotic called an aminoglycoside can improve survival in these patients. However, exposure to these antibiotics can lead to reduced kidney function in around one third of patients by the time theyre adults. Currently we measure a substance called creatinine in blood tests to check how well the kidneys are working. However, creatinine is slow to respond to any damage to the kidney, so we may not find out that damage has occurred until it is too late to reverse it. A number of substances, called biomarkers, can be measured in the urine. We think that some of these biomarkers might be useful at telling us how well a childs kidneys are working, and whether any damage is occurring as a result of treatment with aminoglycosides.
In this study we aim to measure these biomarkers in the urine of children with CF at regular intervals (routine outpatient clinic appointments), and during treatment with an aminoglycoside called tobramycin.
We expect that this research will help us to develop non-invasive urine biomarker tests which can identify kidney damage from aminoglycosides early. We aim to build upon this study to develop new methods of preventing kidney damage from this important group of antibiotics. Our ultimate aim is to improve the long-term outlook for children with CF by ensuring that far fewer develop kidney problems as a result of their treatment, and allow doctors to have access to the antibiotics they require to treat such patients. Ultimately we may be able to replace some uncomfortable blood tests with non-invasive urine tests, therefore reducing the burden on patients.
Who can participate?
Children and young adults with CF aged 0 to 20 years.
What does the study involve?
All participants will provide a urine sample on the day of recruitment (at a CF outpatient clinic) and each time they subsequently come to the clinic. Ideally the sample will be collected by asking the child to go into a toilet cubicle and pass urine into a sterile container. Parents may need to give their child some help with this. If the child is too young or not able to pass urine on demand, there are other ways we can collect the sample. None of these are invasive or painful, and these will be discussed with parents.
If the child has a course of intravenous tobramycin in hospital, or at home with daily community nurse visits, we will collect one urine sample on the same day but before the first dose of tobramycin, and a further urine sample each day during the treatment.
If the child has tobramycin at home without daily community nurse visits we will collect one urine sample on the same day but before the first dose of tobramycin, and a further urine sample on each day that monitoring blood tests are done, and on the final day of treatment.
We will provide parents with the sample pots required. We will also collect a follow-up sample 5-10 days after the last dose of tobramycin. We will arrange either to go and collect this sample, or for parents to bring it to the hospital.
Each child will be involved in the study for at least 1 year, and possibly up to 2 years.
We will store the urine samples in a freezer, and test for different biomarkers at different times. We will keep the sample until it is used up.
What are the possible benefits and risks of participating?
We do not anticipate any problems. We will choose an appropriate urine collection method for each child. There are no immediate benefits.
Where is the study run from?
University of Liverpool and Alder Hey Childrens NHS Foundation Trust
When is study starting and how long is it expected to run for?
The study is starting in April 2012 and is expected to run until October 2014
Who is funding the study?
Medical Research Council.
Who is the main contact?
Dr Steve McWilliam
S.Mcwilliam1@liverpool.ac.uk
Contact information
Scientific
University of Liverpool
Molecular and Clinical Pharmacology
1-3 Brownlow Street
Liverpool
L69 3GL
United Kingdom
| Phone | +44 151 794 2000 |
|---|---|
| S.Mcwilliam1@liverpool.ac.uk |
Study information
| Study design | Observational clinical laboratory study |
|---|---|
| Primary study design | Observational |
| Secondary study design | Cohort study |
| Study setting(s) | Hospital |
| Study type | Diagnostic |
| Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
| Scientific title | URinary Biomarkers of Aminoglycoside-induced Nephrotoxicity in children with Cystic Fibrosis |
| Study acronym | URBAN CF |
| Study objectives | The aim of this study is to measure these biomarkers in the urine of children with cystic fibrosis (CF) at regular intervals (routine outpatient clinic appointments), and during treatment with an aminoglycoside called tobramycin. |
| Ethics approval(s) | NRES Committee North West Liverpool East, 27/02/2012, ref: 12/NW/0122 |
| Health condition(s) or problem(s) studied | Cystic fibrosis / kidney injury |
| Intervention | In this study children and young adults with CF will be asked to provide a number of urine samples. They will provide routine urine samples when they attend outpatient appointments, and they will also provide more frequent urine samples if they receive one or more courses of treatment with tobramycin. Participants will be involved in the study for at least 1 year, and possibly up to 2 years. The urine samples will be analysed for a number of urine biomarkers. The primary aim of the study is to identify whether there are elevations in these urine biomarkers during treatment with tobramycin. |
| Intervention type | Other |
| Primary outcome measure | The mean difference in urinary biomarker value between samples collected during tobramycin treatment, and samples collected when not receiving tobramycin. This will be calculated for each biomarker measured over the time course of each participants involvement in the study. |
| Secondary outcome measures | 1. The association between urinary biomarker values and conventional measures of renal function [serum urea and creatinine, estimated glomerular filtration rate (eGFR)] 2. The association between urinary biomarker values and cumulative lifetime aminoglycoside exposure, compared to biomarker values in children with CF who have never received aminoglycosides and to a healthy children cohort 3. An analysis of changes in urinary biomarker values in the same patient with repeated courses of tobramycin |
| Overall study start date | 01/03/2012 |
| Completion date | 01/10/2014 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Child |
| Lower age limit | 0 Years |
| Upper age limit | 20 Years |
| Sex | Both |
| Target number of participants | Planned Sample Size: 120; UK Sample Size: 120 |
| Key inclusion criteria | 1. Age 0-20 years, either sex (Some patients with CF will continue to be seen in a Paediatric CF clinic beyond the age of 16 and will therefore be included by having a higher upper age limit) 2. Diagnosis of cystic fibrosis (established by sweat test or genotype) |
| Key exclusion criteria | Does not meet inclusion criteria |
| Date of first enrolment | 01/03/2012 |
| Date of final enrolment | 01/10/2014 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
L69 3GL
United Kingdom
Sponsor information
University/education
Whelan Building
Quadrangle
Brownlow Hill
Liverpool
L69 3GL
England
United Kingdom
| Website | http://www.liv.ac.uk/ |
|---|---|
"ROR" |
https://ror.org/04xs57h96 |
Funders
Funder type
Research council
No information available
Results and Publications
| Intention to publish date | |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not provided at time of registration |
| Publication and dissemination plan | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 23/03/2018 | 21/01/2019 | Yes | No |
Editorial Notes
21/01/2019: Publication reference added
18/01/2017: No publications found in PubMed, verifying study status with principal investigator.
