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Effects of Traditional Chinese Medicine (GSJYF) in Children With Inherited Proteinuric Kidney Disease

Primary Purpose

Proteinuria, Kidney Diseases, Hereditary Nephropathy

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
TCM+ Routine Therapy
Routine Therapy
Sponsored by
Children's Hospital of Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Proteinuria focused on measuring Traditional Chinese Medicine, anti-proteinuric

Eligibility Criteria

3 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Aged 3-18 years; Proteinuria associated with hereditary nephropathy, which was confirmed by mutations in podocyte genes or syndromal genes (including collagens); Urine protein more than 500 mg/24 hours and/or UPCR (in first-morning void) more than 0.5 mg/mg at time of baseline despite ACEI or ARB treatment for at least 3 months; Estimated GFR ≥ 45 ml/min/1.73m2 (estimated with Schwartz formula); Without any immunosuppressive medications such as corticosteroids, calcinrurin inhibitors, etc; On a stable dose of ACEI or ARB for at least 4 weeks; Willingness to give written consent and comply with the study protocol. Exclusion Criteria: Diagnosed with Congenital Anomalies of the Kidneys and Urinary Tracts (CAKUT), Nephronophthisis, Polycystic kidney disease etc; With abnormal liver function, ALT or AST >3.0 x upper limit of normal (ULN) at enrolment; Receiving immunosuppressive therapy (including corticosteroids, and other immune suppressive medicine) within three months prior to enrolment; Receiving other traditional Chinese medicine and/or its analogue which can reduce proteinuria within the past 2 weeks. Patients who are taking other TCM treatment could be enrolled after 2 weeks of wash out period; Has undergone major organ transplantation (e.g. heart, kidney, liver); Any medication, surgical or medical condition which might significantly alter the absorption, distribution, or metabolism including, but not limited to any of the following: active inflammatory bowel disease, received major gastrointestinal tract surgery; History of noncompliance to medical regimens or inability to comply with the study and follow-up procedures.

Sites / Locations

  • Anhui Provincial Children's Hospital
  • First Affiliated Hospital, Sun Yat-Sen University
  • Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital
  • Wuhan Children's Hospital,Tongji Medical College, Huazhong University of Science and Technology.
  • Children's Hospital of Nanjing Medical University
  • Shandong Provincal Hospital
  • The Children's Hospital of Zhejiang University School of Medicine
  • Children's Hospital of Fudan UniversityRecruiting
  • Xuzhou Children's HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Traditional Chinese Medicine treatment group

Control group

Arm Description

Patients will receive Gu Shen Juan Yu Formula, 15ml or 30 ml or 60ml each time based on weight (15ml for W≤20kg, 30 mL for 20-30kg, or 60ml for W>30kg), 2 times a day for 12 weeks, orally, as an add-on to any ongoing treatment, including ACE inhibitors/ angiotensin II receptor blocker. Patients receiving a stable dose of ACEI/ARB will be continued.

Patients receive a stable dose of ACEI/ARB drug as a routine therapy.

Outcomes

Primary Outcome Measures

Percentage change in urinary protein-creatinine ratio (UPCR) from baseline to week 12
UPCR in first-morning spot urine samples are measured at baseline, week 4, week 8, and week 12. It is a repeated measurement.
Changes in estimated glomerular filtration rate (eGFR) from baseline to week 12
eGFR will be evaluated using Schwartz formula (eGFR=k*height(cm)/serum creatinine(umol/L)), k=36.5). Serum creatinine are measured at baseline, week 4, week 8, week12. Serum creatinine is a repeated measurement.
Percentage change in urinary albumin-creatinine ratio (UACR) from baseline to week 12
UACR in first-morning spot urine samples are measured at baseline, week 4, week 8, and week 12. UPCR is a repeated measurement.
Percentage change in 24-hour protein from baseline to week 12
24-hour urine samples are measured at baseline, week 4, week 8, and week 12. 24-hour proteinuria is a repeated measurement.

Secondary Outcome Measures

Changes in serum albumin from baseline to week 12
Serum albumin are measured at baseline, week 4, week 8, and week 12. Serum albumin is a repeated measurement.
Changes of Traditional Chinese Medicine syndrome scores after treatment
A TCM syndrome scale points are used to evaluate the Traditional Chinese Medicine syndromes at baseline, and week 12. The minimum values is 0 and maximum values is 36. The higher scores mean a severe status.
Changes in liver function parameters from baseline to week 12: Alanine Aminotransferase (ALT)
Blood samples are measured at baseline, week 4, week 8, week 12 to evaluate ALT
Changes in liver function parameters from baseline to week 12: Aspartate Aminotransferase (AST)
Blood samples are measured at baseline, week 4, week 8, week 12 to evaluate AST

Full Information

First Posted
February 26, 2023
Last Updated
September 25, 2023
Sponsor
Children's Hospital of Fudan University
Collaborators
Anhui Provincial Children's Hospital, Henan Provincial People's Hospital, Wuhan Union Hospital, China, Children's Hospital of Nanjing Medical University, The Children's Hospital of Zhejiang University School of Medicine, First Affiliated Hospital, Sun Yat-Sen University, Shandong Provincial Hospital, Xuzhou Children's Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05759754
Brief Title
Effects of Traditional Chinese Medicine (GSJYF) in Children With Inherited Proteinuric Kidney Disease
Official Title
Treatment Effects of Traditional Chinese Medicine (Gu Shen Juan Yu Formula) in Children With Inherited Proteinuric Kidney Disease:a Multicenter, Open-label, Two-arm, Parallel-design, Randomized Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 17, 2023 (Actual)
Primary Completion Date
July 1, 2024 (Anticipated)
Study Completion Date
October 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Children's Hospital of Fudan University
Collaborators
Anhui Provincial Children's Hospital, Henan Provincial People's Hospital, Wuhan Union Hospital, China, Children's Hospital of Nanjing Medical University, The Children's Hospital of Zhejiang University School of Medicine, First Affiliated Hospital, Sun Yat-Sen University, Shandong Provincial Hospital, Xuzhou Children's Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether traditional Chinese medicine, Gu Shen Juan Yu Formula, as complementary treatment is safe and effective in the treatment of Inherited Proteinuric Kidney Disease.
Detailed Description
Current therapy for inherited protinuric kidney disease remains limited. Renin-angiotensin-aldosterone-system (RAAS) inhibitors such as Angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARBs) help to control proteinuria and slow the progression of kidney function loss. However, a substantial proportion of patients progress to end-stage renal disease, which is partly associated with high residual proteinuria. Novel therapies to decrease proteinuria and limit CKD progression are needed. Traditional Chinese medicine (TCM) has been extensively used in China for thousands of years and favored in treatment of chronic disease for multi-factorial, multi-target action. The investigators' hypothesis is that this traditional Chinese medicine, targeted to podocyte injury and repair named Gu Shen Juan Yu Formula, can significantly reduce proteinuria and delay renal function loss in patients with proteinuric kidney disease. To test this hypothesis, the investigators plan to initiate a multicenter, open-label, two-arm, parallel-design, randomized clinical trial in 144 children with proteinuria kidney disease. The study population will consist of children with proteinuria who are on receiving routine therapy such as ACE inhibitor or angiotensin II receptor blocker treatment. In this study, participants were randomly assigned (1:1) to receive TCM+ Routine Therapy or Routine Therapy for 12 weeks. The primary objective was to measure the change of urine protein excretion and estimated glomerular filtration rate (eGFR) during the treatment period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Proteinuria, Kidney Diseases, Hereditary Nephropathy
Keywords
Traditional Chinese Medicine, anti-proteinuric

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
144 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Traditional Chinese Medicine treatment group
Arm Type
Experimental
Arm Description
Patients will receive Gu Shen Juan Yu Formula, 15ml or 30 ml or 60ml each time based on weight (15ml for W≤20kg, 30 mL for 20-30kg, or 60ml for W>30kg), 2 times a day for 12 weeks, orally, as an add-on to any ongoing treatment, including ACE inhibitors/ angiotensin II receptor blocker. Patients receiving a stable dose of ACEI/ARB will be continued.
Arm Title
Control group
Arm Type
Other
Arm Description
Patients receive a stable dose of ACEI/ARB drug as a routine therapy.
Intervention Type
Drug
Intervention Name(s)
TCM+ Routine Therapy
Other Intervention Name(s)
Gushen Juanyu Formula+ACEI/ARB
Intervention Description
TCM:The Gu Shen Juan Yu Formula contains 11 herbs and it is available in liquid form for patients. Patients will receive Gu Shen Juan Yu Formula, 15ml or 30 ml or 60ml each time based on weight (15ml for W≤20kg, 30 mL for 20-30kg, or 60ml for W>30kg), 2 times a day for 12 weeks, orally. Routine therapy: Patients receiving a stable dose of ACEI/ARB will be continued.
Intervention Type
Drug
Intervention Name(s)
Routine Therapy
Other Intervention Name(s)
ACEI/ARB
Intervention Description
Patients receive a stable dose of ACEI/ARB drug as a routine therapy.
Primary Outcome Measure Information:
Title
Percentage change in urinary protein-creatinine ratio (UPCR) from baseline to week 12
Description
UPCR in first-morning spot urine samples are measured at baseline, week 4, week 8, and week 12. It is a repeated measurement.
Time Frame
baseline, week 4, week 8, week 12
Title
Changes in estimated glomerular filtration rate (eGFR) from baseline to week 12
Description
eGFR will be evaluated using Schwartz formula (eGFR=k*height(cm)/serum creatinine(umol/L)), k=36.5). Serum creatinine are measured at baseline, week 4, week 8, week12. Serum creatinine is a repeated measurement.
Time Frame
baseline, week 4, week 8, week 12
Title
Percentage change in urinary albumin-creatinine ratio (UACR) from baseline to week 12
Description
UACR in first-morning spot urine samples are measured at baseline, week 4, week 8, and week 12. UPCR is a repeated measurement.
Time Frame
baseline, week 4, week 8, week 12
Title
Percentage change in 24-hour protein from baseline to week 12
Description
24-hour urine samples are measured at baseline, week 4, week 8, and week 12. 24-hour proteinuria is a repeated measurement.
Time Frame
baseline, week 4, week 8, week 12
Secondary Outcome Measure Information:
Title
Changes in serum albumin from baseline to week 12
Description
Serum albumin are measured at baseline, week 4, week 8, and week 12. Serum albumin is a repeated measurement.
Time Frame
baseline, week 4, week 8, week 12
Title
Changes of Traditional Chinese Medicine syndrome scores after treatment
Description
A TCM syndrome scale points are used to evaluate the Traditional Chinese Medicine syndromes at baseline, and week 12. The minimum values is 0 and maximum values is 36. The higher scores mean a severe status.
Time Frame
Baseline, week 12
Title
Changes in liver function parameters from baseline to week 12: Alanine Aminotransferase (ALT)
Description
Blood samples are measured at baseline, week 4, week 8, week 12 to evaluate ALT
Time Frame
baseline, week 4, week 8, week 12
Title
Changes in liver function parameters from baseline to week 12: Aspartate Aminotransferase (AST)
Description
Blood samples are measured at baseline, week 4, week 8, week 12 to evaluate AST
Time Frame
baseline, week 4, week 8, week 12
Other Pre-specified Outcome Measures:
Title
Number of subjects reporting adverse events (AEs)during the treatment period
Description
Number of subjects with AEs as a measure of safety
Time Frame
baseline, week 4, week 8, week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 3-18 years; Proteinuria associated with hereditary nephropathy, which was confirmed by mutations in podocyte genes or syndromal genes (including collagens); Urine protein more than 500 mg/24 hours and/or UPCR (in first-morning void) more than 0.5 mg/mg at time of baseline despite ACEI or ARB treatment for at least 3 months; Estimated GFR ≥ 45 ml/min/1.73m2 (estimated with Schwartz formula); Without any immunosuppressive medications such as corticosteroids, calcinrurin inhibitors, etc; On a stable dose of ACEI or ARB for at least 4 weeks; Willingness to give written consent and comply with the study protocol. Exclusion Criteria: Diagnosed with Congenital Anomalies of the Kidneys and Urinary Tracts (CAKUT), Nephronophthisis, Polycystic kidney disease etc; With abnormal liver function, ALT or AST >3.0 x upper limit of normal (ULN) at enrolment; Receiving immunosuppressive therapy (including corticosteroids, and other immune suppressive medicine) within three months prior to enrolment; Receiving other traditional Chinese medicine and/or its analogue which can reduce proteinuria within the past 2 weeks. Patients who are taking other TCM treatment could be enrolled after 2 weeks of wash out period; Has undergone major organ transplantation (e.g. heart, kidney, liver); Any medication, surgical or medical condition which might significantly alter the absorption, distribution, or metabolism including, but not limited to any of the following: active inflammatory bowel disease, received major gastrointestinal tract surgery; History of noncompliance to medical regimens or inability to comply with the study and follow-up procedures.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hong Xu, PhD
Phone
+86-02164932825
Email
hxu@shmu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Qian Shen, PhD
Phone
86-02164932827
Email
shenqian@shmu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hong Xu, PhD
Organizational Affiliation
Children's Hospital of Fudan University
Official's Role
Study Chair
Facility Information:
Facility Name
Anhui Provincial Children's Hospital
City
Hefei
State/Province
Anhui
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Deng Fang
First Name & Middle Initial & Last Name & Degree
Zhou huiqin
Facility Name
First Affiliated Hospital, Sun Yat-Sen University
City
Guangzhou
State/Province
Guangzhou
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jiang Xiaoyun
Facility Name
Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liu Cuihua
Facility Name
Wuhan Children's Hospital,Tongji Medical College, Huazhong University of Science and Technology.
City
Wuhan
State/Province
Hubei
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wang Xiaowen
Facility Name
Children's Hospital of Nanjing Medical University
City
Nanjing
State/Province
Jiangsu
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhang Aihua
Facility Name
Shandong Provincal Hospital
City
Shandong
State/Province
Shandong
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sun Shuzheng
Facility Name
The Children's Hospital of Zhejiang University School of Medicine
City
Hangzhou
State/Province
Zhejiang
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mao Jianhua
Facility Name
Children's Hospital of Fudan University
City
Shanghai
ZIP/Postal Code
201102
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xu Hong, PhD,MD
Phone
+86-02164932829
Email
hxu@shmu.edu.cn
Facility Name
Xuzhou Children's Hospital
City
Xuzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhang ruifeng

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Effects of Traditional Chinese Medicine (GSJYF) in Children With Inherited Proteinuric Kidney Disease

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