AUTHOR=Hilbrands Luuk , Budde Klemens , Bellini Maria Irene , Diekmann Fritz , Furian Lucrezia , Grinyó Josep , Heemann Uwe , Hesselink Dennis A. , Loupy Alexandre , Oberbauer Rainer , Pengel Liset , Reinders Marlies , Schneeberger Stefan , Naesens Maarten TITLE=Allograft Function as Endpoint for Clinical Trials in Kidney Transplantation JOURNAL=Transplant International VOLUME=35 YEAR=2022 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10139 DOI=10.3389/ti.2022.10139 ISSN=1432-2277 ABSTRACT=

Clinical study endpoints that assess the efficacy of interventions in patients with chronic renal insufficiency can be adopted for use in kidney transplantation trials, given the pathophysiological similarities between both conditions. Kidney dysfunction is reflected in the glomerular filtration rate (GFR), and although a predefined (e.g., 50%) reduction in GFR was recommended as an endpoint by the European Medicines Agency (EMA) in 2016, many other endpoints are also included in clinical trials. End-stage renal disease is strongly associated with a change in estimated (e)GFR, and eGFR trajectories or slopes are increasingly used as endpoints in clinical intervention trials in chronic kidney disease (CKD). Similar approaches could be considered for clinical trials in kidney transplantation, although several factors should be taken into account. The present Consensus Report was developed from documentation produced by the European Society for Organ Transplantation (ESOT) as part of a Broad Scientific Advice request that ESOT submitted to the EMA in 2020. This paper provides a contemporary discussion of primary endpoints used in clinical trials involving CKD, including proteinuria and albuminuria, and evaluates the validity of these concepts as endpoints for clinical trials in kidney transplantation.