Clinical Trial: Metabolic Acidosis in Renal Transplant Patients

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Metabolic Acidosis and Its Impact on Mineral Metabolism and Physical Performance in Renal Transplant Patients

Brief Summary:

Acidosis (accumulation of acid in the body) may be an underrecognized problem in patients after renal transplantation. It may have consequences on physical performance due to negative effects on bone and muscle metabolism.

Therefore, the purpose of this study is

  1. to determine the status of physical capacity and bone structure in renal transplant patients with metabolic acidosis
  2. to study the effect of substituting base equivalents (citrate) on acid/base status of renal transplant patients with acidosis
  3. to compare the status of physical capacity and bone structure in renal transplant patients with metabolic acidosis before and after substitution with citrate

Detailed Summary:

Chronic kidney disease is developing to become one of the major health problems in the Western world with more than one million patients on renal replacement therapy, and many more expected in the years ahead [1]. Survival of patients with end stage renal disease has become possible with the introduction of dialysis therapy. Renal transplantation has resulted both in further reduction of mortality and improvement in quality of life for patients with end stage renal disease. Nevertheless, successful transplantation with regard to graft and patient survival is still associated with significant morbidity. Apart from infectious complications and cardiovascular disease, limitations in physical capacity from musculoskeletal disorders have become a relevant problem, resulting in reduced quality of life, poor physical functioning and inability to work.

Muscle and bone metabolism in chronic kidney disease are typically disturbed resulting in significant pathology and dysfunction of the affected tissues. They are associated with metabolic disorders related to renal insufficiency, among which metabolic acidosis is a major contributor. Metabolic acidosis is a well recognized problem in renal transplant patients. However, its prevalence, pathogenesis, course and sequelae are not well established. In particular, its relation to post-transplant bone and muscle disorders, and the impact on physical capabilities in renal transplant patients have not been comprehensively investigated so far.

The purpose of the proposed project is to examine the characteristics and pathogenesis of post-transplant metabolic acidosis, and its relation to bone and muscle pathologies and impact on physical capabilities in renal transplant patients. In particular, the following aims are proposed to investigate in de novo and long-term renal transplantation:

<
Sponsor: University of Zurich

Current Primary Outcome: Correction of metabolic acidosis [ Time Frame: 12 months ]

Original Primary Outcome: Same as current

Current Secondary Outcome: Improvement in physical capacity [ Time Frame: 12 months ]

Original Secondary Outcome: Same as current

Information By: University of Zurich

Dates:
Date Received: April 1, 2009
Date Started: December 2007
Date Completion:
Last Updated: October 21, 2010
Last Verified: June 2009