A Pilot Trial of taVNS for SRNS in Children (kidNEY-VNS)

Description

Children with steroid resistant nephrotic syndrome (SRNS) are exposed to prolonged courses of immunosuppressant medications. Given the adverse side effect profiles and variable efficacy of these medications, there is an urgent need to identify novel and safe therapies to treat nephrotic syndrome in children. Stimulation of the vagus nerve, which can be activated noninvasively by transcutaneous auricular vagus nerve stimulation (taVNS), has immunomodulatory effects mediated by the inflammatory reflex and spleen. taVNS has become a therapy of interest for treating chronic immune mediated illnesses. The aims of the study are (1) To determine the feasibility of protocol implementation and tolerability of taVNS in the treatment of nephrotic syndrome in children (2) To establish proof-of-concept and generate statistical estimates of variance parameters and effect sizes for treatment response outcomes in children with nephrotic syndrome randomized to taVNS therapy compared with sham therapy (3) To investigate the effects of taVNS on inflammatory markers in children with nephrotic syndrome.

Conditions

Nephrotic Syndrome in Children, Minimal Change Disease, Focal Segmental Glomerulosclerosis

Study Overview

Study Details

Study overview

Children with steroid resistant nephrotic syndrome (SRNS) are exposed to prolonged courses of immunosuppressant medications. Given the adverse side effect profiles and variable efficacy of these medications, there is an urgent need to identify novel and safe therapies to treat nephrotic syndrome in children. Stimulation of the vagus nerve, which can be activated noninvasively by transcutaneous auricular vagus nerve stimulation (taVNS), has immunomodulatory effects mediated by the inflammatory reflex and spleen. taVNS has become a therapy of interest for treating chronic immune mediated illnesses. The aims of the study are (1) To determine the feasibility of protocol implementation and tolerability of taVNS in the treatment of nephrotic syndrome in children (2) To establish proof-of-concept and generate statistical estimates of variance parameters and effect sizes for treatment response outcomes in children with nephrotic syndrome randomized to taVNS therapy compared with sham therapy (3) To investigate the effects of taVNS on inflammatory markers in children with nephrotic syndrome.

A Pilot Randomized Clinical Trial of Transcutaneous Auricular Vagus Nerve Stimulation for the Treatment of Steroid Resistant Nephrotic Syndrome in Children

A Pilot Trial of taVNS for SRNS in Children (kidNEY-VNS)

Condition
Nephrotic Syndrome in Children
Intervention / Treatment

-

Contacts and Locations

New Hyde Park

Cohen Children's Medical Center, New Hyde Park, New York, United States, 11040

Philadelphia

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States, 19104

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Steroid Resistant Nephrotic Syndrome- defined as lack of remission after 4 weeks of therapy of prednisolone/prednisone at standard dose1
  • * Age 3-17 years
  • * eGFR ≥30 ml/min/1.73 m2 (by modified Schwartz formula)
  • * MCD or FSGS diagnosis (per biopsy)
  • * Urine protein:creatinine (UPC) greater than 1.0
  • * Stable immunosuppression and ACE inhibitor/angiotensin receptor blocker treatment regimen for at least three months
  • * Evidence of B cell repletion for those exposed to rituximab
  • * Informed consent from the parent or guardian and assent from a minor of ≥ 7 years
  • * Ability to comply with the study protocol, in the investigator's judgment
  • * Secondary causes of nephrotic syndrome (e.g. genetic, congenital, infectious)
  • * Steroid sensitive nephrotic syndrome
  • * History of genetic defects known to directly cause nephrotic syndrome (i.e., NPHS2 \[podocin\], NPHS1 \[nephrin\], PLCE1, WT1, or other known genetic cause)
  • * Any known inflammatory condition
  • * History of cardiac disease (arrhythmias, structural/functional abnormalities)
  • * Implantable electronic devices (pacemakers, defibrillators, hearing aids, cochlear implants or deep brain stimulators)
  • * Chronic rash or skin breakdown of the left ear at the cymba concha
  • * Pregnancy

Ages Eligible for Study

3 Years to 17 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Northwell Health,

Study Record Dates

2025-08-01