Effect of Statin Therapy on Disease Progression in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to determine whether the medication pravastatin will ameliorate renal and cardiovascular disease over a 3-year period in children and young adults with autosomal dominant polycystic kidney disease (ADPKD).

Detailed Description
-----------------
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, affecting 1 in 400 to 1000 individuals and accounting for 4% of end-stage renal disease in the United States and 8-10% in Europe. The condition is characterized by progressive development of kidney cysts with kidney enlargement and associated loss of kidney function. High blood pressure and cardiovascular disease are common in patients with ADPKD. Although the condition is often thought to affect primarily adults, it is clear that the disease can be present in the fetus and young children. This study was designed to determine if treatment with the medicine pravastatin can slow the progression of kidney and heart disease when initiated early in life in patients with ADPKD. The Investigators will assess differences between pravastatin and placebo study groups over the three-year study period with respect to: 1) total kidney volume as assessed by magnetic resonance imaging (MRI); 2) left ventricular mass index as assessed by MRI; 3) urinary albumin excretion; and 4) endothelial-dependent vasodilation as assessed by brachial ultrasound. A total of 110 subjects were enrolled in this research study. This study involved pediatric subjects because the Investigators believe that early intervention is critical if they are to decrease the morbidity and mortality associated with this condition. If pravastatin is shown to be effective in ameliorating progression of renal and cardiovascular disease in this study, routine management of people with this condition will be drastically altered.

Official Title
-----------------
Effect of Statin Therapy on Disease Progression in Autosomal Dominant Polycystic Kidney Disease

Conditions
-----------------
Polycystic Kidney, Autosomal Dominant

Intervention / Treatment
-----------------
* Drug: pravastatin
* Drug: Placebo


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age 8-22 years Autosomal dominant polycystic kidney disease Normal kidney function Exclusion Criteria: Abnormal kidney function Past allergic history to medications used in study Liver disease Muscle disease/dystrophy Pregnancy, planned pregnancy, or lactation within study period Inability to cooperate with or clinical contraindication for magnetic resonance imaging

Ages Eligible for Study
-----------------
Minimum Age: 8 Years
Maximum Age: 22 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pravastatin<br>Pravastatin | Drug: pravastatin<br>* Pravastatin 20 mg daily (subject age 8-12 years) or 40 mg daily (subject age 13-21 years)<br>|
| Placebo Comparator: Placebo<br>Placebo | Drug: Placebo<br>* Placebo daily<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent of Participants Demonstrating 20% or More Increase in Total Kidney Volume | Percent of participants demonstrating 20% or more increase in total kidney volume corrected for height, left ventricular mass index, or urinary albumin excretion over the three year study period | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage Change in Total Kidney Volume Corrected for Height |  | 3 years | 
| Left Ventricular Mass Index | left ventricular mass index in g/m^2 by MRI | 3 years | 
| Urinary Albumin Excretion |  | 3 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Autosomal dominant polycystic kidney disease, Cystic kidney disease, High blood pressure, Statin