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L-arginine for Prevention of Kidney Damage in Liver Transplant Recipients

This study has been completed.
National Center for Complementary and Integrative Health (NCCIH)
Information provided by (Responsible Party):
W. Ray Kim, Mayo Clinic Identifier:
First received: December 21, 2007
Last updated: August 30, 2012
Last verified: August 2012
Chronic renal insufficiency is a common and important health problem that causes morbidity and mortality among patients who have undergone liver transplantation. It is mainly caused by drugs (calcineurin inhibitors) that are used to prevent or treat rejection and once established, there is no effective treatment. This research investigates whether L-arginine can reverse the effects of calcineurin inhibitors on the kidneys and thus prevent renal insufficiency in liver transplant recipients.

Condition Intervention
Liver Transplant Recipients Dietary Supplement: L-arginine Dietary Supplement: Placebo

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: L-arginine Supplement for the Prevention of Calcineurin Inhibitor Nephrotoxicity

Resource links provided by NLM:

Further study details as provided by W. Ray Kim, Mayo Clinic:

Primary Outcome Measures:
  • Changes in eGFR before and after L-arginine [ Time Frame: 7 days with option for 12 week maintenance phase ]

Secondary Outcome Measures:
  • Urinary excretion of cGMP before and after L-arginine. Creatinine before and after L-arginine. [ Time Frame: 7 days with option for 12 week maintenance phase ]
  • Safety of oral L-arginine [ Time Frame: 7 days with option for 12 week maintenance phase ]
  • Change in iothalamate clearance before and after optional 12 week maintenance open label phase. [ Time Frame: 12 weeks ]

Enrollment: 24
Study Start Date: November 2008
Study Completion Date: July 2012
Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arginine Dietary Supplement: L-arginine
Arginaid (Novartis) 1 package (9.2g) bid for 7 days
Placebo Comparator: Placebo Dietary Supplement: Placebo
Placebo powder 9.2g bid for 7 days

  Show Detailed Description


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria

  1. Informed written consent
  2. Ages 18+ at the time of entry into the study
  3. Recipient of primary liver transplantation from a deceased or live donor
  4. Stable with satisfactory allograft function

    1. Total bilirubin < 2.5 mg/dl and
    2. Aminotransferase < x 3 upper limit of normal (e.g., ALT<120 IU/mL)
  5. Serum creatinine < 2.5 mg/dl without dialysis
  6. Maintenance immunosuppression including tacrolimus or cyclosporine
  7. Stable hemodynamic function

    1. Systolic blood pressure > 100 mmHg
    2. Resting pulse rate < 100

Exclusion criteria

  1. Recipient of combined liver-kidney transplantation
  2. Prior organ transplantation (i.e., exposure to calcineurin inhibitors)
  3. Established primary renal disease with active urinary sediments
  4. On-going renal replacement therapy
  5. Pulmonary hypertension (e.g., portopulmonary hypertension)
  6. Iodine allergy
  7. Other systemic illness (e.g., infection) that require hospitalization care beyond 2 weeks after LTx
  Contacts and Locations
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Please refer to this study by its identifier: NCT00587418

United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
National Center for Complementary and Integrative Health (NCCIH)
Principal Investigator: W. Ray Kim Mayo Clinic
  More Information

Additional Information:
Responsible Party: W. Ray Kim, Associate Professor of Medicine, Mayo Clinic Identifier: NCT00587418     History of Changes
Other Study ID Numbers: 06-007047
R21AT004174 ( U.S. NIH Grant/Contract )
Study First Received: December 21, 2007
Last Updated: August 30, 2012

Additional relevant MeSH terms:
Calcineurin Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action processed this record on September 21, 2017