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Trial registered on ANZCTR
Registration number
ACTRN12610000076077
Ethics application status
Approved
Date submitted
18/01/2010
Date registered
20/01/2010
Date last updated
2/03/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Randomised Controlled Trial to determine the appropriate time to initiate peritoneal dialysis after insertion of catheter to minimise complications in end stage renal disease patients (Timely Peritoneal dialysis study)
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Scientific title
Randomised Controlled Trial to determine the appropriate time to initiate peritoneal dialysis after insertion of catheter to minimise complications in end stage renal disease patients (Timely Peritoneal dialysis study )
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Secondary ID [1]
288682
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Nil known
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Universal Trial Number (UTN)
N/A
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Trial acronym
Timely PD study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chroinc kidney disease complications
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Condition category
Condition code
Renal and Urogenital
256774
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
1. All patients who met the inclusion and exclusion criteria and who underwent surgical peritoneal dialysis (PD) catheter insertion at the Royal Brisbane and Women’s Hospital (RBWH) and Rockhampton Base Hospital (RKH ) are invited to participate in the study. These participants were not on PD before and will be starting PD for the first time.
2. Tenckhoff curled PD catheters are inserted by the same surgical teams ( general surgery consultant /team) at each centre.
Participants were randomised to PD initiation interval, Group 1 (G1) commenced PD at one week, group 2 (G2) at two and group 3 (G3) at four weeks after insertion of PD catheter. Participants were also stratified by diabetic status.
All participants received formal PD training. Participants initiated PD with similar patterns of clinical practice apart from the randomised varying PD intervals. The PD catheter exit site and tunnel were examined according to standard clinical practice.
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Intervention code [1]
255864
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Treatment: Devices
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Comparator / control treatment
Control Group is 2 weeks
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Control group
Active
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Outcomes
Primary outcome [1]
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Peritoneal fluid leaks and infection (over the four weeks following start up of peritoneal dialysis; Leak by observation during clinical examination; infection by chemical analysis of peritoneal dialysis fluid )
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Assessment method [1]
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Timepoint [1]
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4 weeks from initiation of dialysis
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Secondary outcome [1]
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Composite of all PD catheter related complications such as infection at exit site by clinical observation and will be confirmed by microbiological tests.
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Assessment method [1]
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Timepoint [1]
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8 weeks from catheter insertion
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Secondary outcome [2]
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Hemodialysis related complications such as infection and catheter related complications. These complications will be assessed by clinical examination/ tests
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Assessment method [2]
262912
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Timepoint [2]
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8 weeks from PD catheter insertion
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Eligibility
Key inclusion criteria
1. end stage kidney disease
2. patients likely to start peritoneal dialysis in the 4 weeks after insertion of a Tenckhoff catheter
4.surgical or peritoneoscopic insertion of a Tenckhoff catheter
5.18 yrs or over
6. able to give informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. patients with a history of psychological illness or condition which interferes with their ability to understand or comply with the requirements of the study.
2.recent (within 4 weeks ) acute infection.
3. patients in whom peritoneal dialysis is contraindicated or not desired
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants are randomised to different arms . The participants are block randomised in equal proportions
to the three treatment groups using randomly
varying blocks The randomisation
sequence was generated using Stata 11 software .
Group 1 will start dialysis one week after Tenckhoff catheter
insertion, group 2 at two weeks and group 3 at four
weeks. A research nurse independent of study nurses and
physicians will undertake randomisation process.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomisation sequence was generated using Stata 11 software
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Participants will be stratified by site and diabetic status
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
To obtain 80% power with
an overall 1-sided significance level of 0.05, approximately
105 patients are required per group to establish
non-inferiority, defined as a difference in complication
rates less than 10% between two groups. It was assumed
that the expected complication rate was 3% as estimated
from the preliminary data, and the significance level was
adjusted for multiple comparisons.
Interim analysis was done
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/09/2008
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Actual
15/09/2008
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Date of last participant enrolment
Anticipated
31/12/2013
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Actual
9/05/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
315
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Accrual to date
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Final
122
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Queensland Health
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Address [1]
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Royal Brisbane & Women's Hospitals,Butterfield Street Herston ,Queensland,4029
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Queensland Health
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Address
Department of Renal Medicine
Level 9 ,Ned Hanlon Building ,Butterfield street, Herston,Queensland,4029
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Country
Australia
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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Baxter Clinical Educational Council
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Address [1]
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Renal Division
Baxter Healthcare Corporation
T: +1.450.226.3273 direct
T: +1.847.473.6193 McGaw Park
M: +1.450.240.5330
F: +1.847.473.6903
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Country [1]
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United States of America
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Brisbane and women's Hospitals Research and Ethics Committee
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Ethics committee address [1]
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Level 7, Block 7 Royal Brisbane and Women's Hospital HERSTON QLD 4029
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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22/10/2007
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Approval date [1]
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02/02/2008
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Ethics approval number [1]
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HREC/RBWH/ 2007/171
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Summary
Brief summary
The planned study targets patients with end stage kidney disease who choose peritoneal dialysis for maintenance therapy. Current practice at the Royal Brisbane and Women's Hospital is to wait four weeks after a Teckhoff catheter is placed before starting peritoneal dialysis . The literature lacks evidence of the optimal interval between peritoneal catheter insertion and start up of dialysis. Consequently practice varies. They too support delayed use but do not test different delay intervals and can not tell us the optimal time. A few recent studies reported a very low leak incidence after using catheter 1 week post insertion , attributed to a tight catheter securing. Any delay in starting PD results in temporary haemodialysis in patients who require immediate dailysis. Temporary haemodialysis requires a central venous access with attendant risk of complications. Temporary haemodialysis is more expensive than peritoneal dialysis . Therefore guidelines bodies, such as CARI (Caring for Australasians with Renal Impairment,), European Dialysis and Transplant Association-European Renal Association and International Society for Peritoneal Dialysis suggest a two week delay. They can can only publish suggestions based on the weak body of evidence, or lack thereof. CARI suggests randomised control trial as there is insufficient evidence for this to be a “guideline’’. The primary objective of this study is to determine the safest and shortest time interval between surgical placement of a Tenckhoff catheter and starting dialysis. The hypothesis is that there is no difference in complication rates between one, two and four week time intervals. If equivalence is proven between one, two and four week time intervals, we could justifiably change practice. Benefits for future patients include shorter exposure to haemodialysis treatments and their complications and shorter duration of haemodialysis catheter placement and its complications. If the results show more complications in the one or two week time interval groups, then we would encourage re-visiting the guidelines. catheter placement and its complications.
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Trial website
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Trial related presentations / publications
Trial has been published at BMC Nephrology Ranganathan D, Baer R, Fassett R, Williams N,., Watson M, Han T and Healy.H Randomised Controlled Trail to Determine the appropriate time to initiate peritoneal Dialysis Ranganathan D et al , BMC Nephrology 2010,11.11
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Public notes
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Contacts
Principal investigator
Name
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Dr Dwarakanathan Ranganathan
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Address
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Department of Renal Medicine
Royal Brisbane & Women's Hospital
Butterfield Street
Herston QLD 4029
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Country
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Australia
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Phone
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+61736468576
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Dwarakanathan Ranganathan
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Address
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Senior Consultant Nephrologist
Royal brisbane & Women's Hospitals
Herston. Queensland, 4029
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Country
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Australia
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Phone
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+61 -07-36368576
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Fax
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+61- 07-36368572
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Dwarakanathan Ranganathan
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Address
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Senior Consultant Nephrologist
Royal brisbane &women's Hospitals
Herston. Queensland, 4029
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Country
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Australia
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Phone
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+61736468576
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Fax
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+61736468572
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Randomised Controlled Trial to determine the appropriate time to initiate peritoneal dialysis after insertion of catheter to minimise complications (Timely PD study)
2010
https://doi.org/10.1186/1471-2369-11-11
Embase
A randomized controlled trial to determine the appropriate time to initiate peritoneal dialysis after insertion of catheter (Timely PD study).
2017
https://dx.doi.org/10.3747/pdi.2016.00066
N.B. These documents automatically identified may not have been verified by the study sponsor.
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