Proteinuria as an Endpoint in Clinical Trials of Focal Segmental Glomerulosclerosis.

IF 9.4 1区 医学 Q1 UROLOGY & NEPHROLOGY
Laura H Mariani, Howard Trachtman, Aliza Thompson, Barbara S Gillespie, Michelle Denburg, Ulysses Diva, Duvuru Geetha, Peter J Greasley, Michelle A Hladunewich, Robert B Huizinga, Jula K Inrig, Radko Komers, Louis-Philippe Laurin, Dustin J Little, Patrick H Nachman, Kimberly A Smith, Liron Walsh, Keisha L Gibson
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Abstract

Focal Segmental Glomerulosclerosis (FSGS) is a characteristic histopathological lesion that is indicative of underlying glomerular dysfunction. It is not a single disease entity but rather a heterogeneous disorder that is an important cause of nephrotic syndrome and kidney failure in children and adults. The aim of this Kidney Health Initiative project was to evaluate potential endpoints for clinical trials in FSGS. This paper focuses on the data supporting proteinuria as a surrogate endpoint. Available data support the use of complete remission of proteinuria in patients with heavy proteinuria as a surrogate endpoint for progression to kidney failure. While substantial treatment effects on proteinuria that are short of a complete remission may also predict the effect of a treatment on progression to kidney failure, further work is needed to determine how such an endpoint should be defined. Fortunately, efforts are underway to bring together patient-level data from randomized controlled trials, observational studies, and registries to address this issue.

将蛋白尿作为局灶性肾小球硬化症临床试验的终点。
局灶性肾小球硬化症(FSGS)是一种特征性组织病理学病变,表明潜在的肾小球功能障碍。它不是一种单一的疾病实体,而是一种异质性疾病,是导致儿童和成人肾病综合征和肾衰竭的重要原因。肾脏健康倡议项目旨在评估 FSGS 临床试验的潜在终点。本文重点介绍支持将蛋白尿作为替代终点的数据。现有数据支持将重度蛋白尿患者的蛋白尿完全缓解作为肾衰竭进展的替代终点。虽然对蛋白尿的实质性治疗效果未达到完全缓解,但也可以预测治疗对肾衰竭进展的影响,因此还需要进一步的工作来确定如何定义这一终点。幸运的是,目前正在努力汇集来自随机对照试验、观察性研究和登记处的患者水平数据来解决这一问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Kidney Diseases
American Journal of Kidney Diseases 医学-泌尿学与肾脏学
CiteScore
20.40
自引率
2.30%
发文量
732
审稿时长
3-8 weeks
期刊介绍: The American Journal of Kidney Diseases (AJKD), the National Kidney Foundation's official journal, is globally recognized for its leadership in clinical nephrology content. Monthly, AJKD publishes original investigations on kidney diseases, hypertension, dialysis therapies, and kidney transplantation. Rigorous peer-review, statistical scrutiny, and a structured format characterize the publication process. Each issue includes case reports unveiling new diseases and potential therapeutic strategies.
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