Prognosis Study of Renal Transplantation in Children

Study Overview
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Brief Summary
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Kidney transplantation is the worldwide recognized best renal replacement treatment for children with end-stage renal disease. Successful kidney transplantation can not only alleviate uremia symptoms, improve survival and quality of life, but also achieve optimal growth and cognitive development in children. Clarifying the cause of end-stage renal disease before transplantation is of vital importance to the comprehensive assessment and follow-up of the extra renal organs, reducing the risk of recurrence of the primary disease, the choice of the timing and the mode of transplantation, the scheme of immunosuppressive agents, as well as providing accurate genetic counseling for families. Timely molecular diagnosis and correct data analysis play a positive role in promoting the etiological diagnosis of uremic children before renal transplantation. We hypothesized that identifying the molecular diagnosis can improve prognosis of kidney transplantation. 300 cases of end-stage renal disease children were included and whole exome sequencing are performed to identify the molecular diagnosis. The cohort was divided into 2 groups according to whether the molecular diagnosis was clear. Clinical information before and after renal transplantation of each group are collected, and the decision tree analysis model and logistic regression model are used to study the effect of clear molecular diagnosis on the 3 year survival rate of renal transplantation.

Official Title
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A Study for Predicting the Prognosis of Renal Transplantation by the Clear Pathogenic Gene of End-stage Renal Disease in Children

Conditions
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Kidney Failure

Intervention / Treatment
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* Diagnostic Test: molecular diagnosis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Donors and recipients who accepted kidney transplantation at centers included in this study Exclusion Criteria: Older than 18 years old. There are severe systemic diseases and/or local and/or spiritual system diseases. There are systemic acute or chronic infections, infectious diseases. The donated organ dysfunction, or other causes that are damage to donors and recipients.

Ages Eligible for Study
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Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| molecular diagnosis confirmed<br>Whole exome sequencing is applied to children and the molecular diagnosis was identified before renal transplantation. | Diagnostic Test: molecular diagnosis<br>* whole exome sequencing and data analysis to elucidating molecular diagnosis<br>|
| molecular diagnosis unconfirmed<br>Whole exome sequencing is applied to children and the molecular diagnosis was not identified before renal transplantation. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Renal graft survival rate | The number of survival renal transplant graft in the 3 year observation period accounted for the percentage of the total cases studied. | 3 years after renal transplantation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of acute rejection | The number of acute rejection after transplantation during the 3 year observation period accounted for the percentage of the total cases studied. | 3 years after renal transplantation | 
| Recurrence rate of primary disease | The number of patient with primary disease recurrence during the 3 year observation period accounted for the percentage of the total cases studied. | 3 years after renal transplantation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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prognosis, pathogenic gene, decision tree study