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Trial registered on ANZCTR
Registration number
ACTRN12608000006347
Ethics application status
Approved
Date submitted
31/12/2007
Date registered
8/01/2008
Date last updated
22/08/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Dialysis exchange free treatment for peritonitis in peritoneal dialysis ( a safety trial)
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Scientific title
Use of Icodextrin® Dialysate with an exchange free period in the initial treatment of peritoneal dialysis associated peritonitis: A Pilot Study
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Secondary ID [1]
283060
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
peritonitis
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peritoneal dialysis
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Condition category
Condition code
Renal and Urogenital
2780
2780
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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
dialysis exchange free interval in peritoneal dialysis patients presenting with peritonitis , use of Intraperitoneal Icodextrin (2500mls of 7.5%) for dialysis in conjunction with dry exchanges for 2 days post peritonitis onset. thereafter patients continue as per standard treatment.Intraperitoneal antibiotics are added to one exhange /day.
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Intervention code [1]
2402
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Treatment: Other
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Comparator / control treatment
standard treatment
Peritoneal dialysis involving 3- 5 exchanges/day with intraperitoneal glucose containing solutions of either 1.5%, 2.5%or 4.25% (1.5L.2l ,2.5L or 3ldepending on the patients regular dialysis prescription) for 2 weeks post peritonitis onset. Follow up is for 2 weeks post peritonitis onset. Intraperitoneal antibiotics are added to one exhange /day.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to resolution of peritonitis
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Assessment method [1]
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Timepoint [1]
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14 days
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Primary outcome [2]
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removal of Tenchkoff catheters.
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Assessment method [2]
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Timepoint [2]
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14days
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Secondary outcome [1]
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relapse of peritonitis
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Assessment method [1]
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Timepoint [1]
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4 weeks
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Secondary outcome [2]
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serum urea and creatinine by lab testing
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Assessment method [2]
6191
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Timepoint [2]
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14 days
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Secondary outcome [3]
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ultrafiltration capacity- by weighing the peritoneal effluent.
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Assessment method [3]
6192
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Timepoint [3]
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14 days
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Secondary outcome [4]
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death
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Assessment method [4]
6193
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Timepoint [4]
6193
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3 months
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Secondary outcome [5]
6194
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technique failure by documenting transfer to haemodialysis
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Assessment method [5]
6194
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Timepoint [5]
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3 months
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Secondary outcome [6]
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hospitalization
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Assessment method [6]
6195
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Timepoint [6]
6195
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14 days
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Secondary outcome [7]
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Monitoring of systemic and peritoneal markers of inflammation and fibrosis by blodd and peritoneal fluid testing.
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Assessment method [7]
6196
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Timepoint [7]
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14 days
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Eligibility
Key inclusion criteria
Age 18 years or over
Ability to give informed consent
Diagnosis of End stage renal disease
Subjects on Peritoneal dialysis for at least a month and has had a baseline PET study.
Prevalent patients on peritoneal dialysis presenting with peritonitis (Dialysate white cell count- WCC > 100cells/HPF and > 50% polymorphonuclear leukocytes PMNL)
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Minimum age
18
Years
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Maximum age
N/A
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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
Subjects with a severe mental disability or psychiatric disorder that interferes with their ability to give informed consent and /or comply with study procedures.
Diabetic patients requiring insulin or using non-glucose oxidase based systems (Advantage) for blood sugar monitoring.
Female subjects who are pregnant, lactating or planning to become pregnant.
Note: female subjects of childbearing potential must not be pregnant or lactating and must be using a medically acceptable means of contraception.
Peritonitis in the previous month.
Subjects unable to receive inraperitoneal antibiotics for the treatment of their peritonitis.
Previous hypersensitivity to Icodextrin®
Subjects who have glycogen storage disease
Subjects with maltose or isomaltose intolerance
Chronically underdialysed patients with the most recent serum urea =35 mmol/l and a serum potassium = 5.8mmol/l.
Subjects with mean arterial blood pressure (MAP) = 150 mm Hg on presentation.
Subjects who have ongoing clinically significant congestive heart failure (New York heart Association Class III or IV)
Subjects with concomitant participation in any other interventional study affecting PD solution prescription.
Subjects who have any medical condition that, in the judgement of the investigators, would jeopardise the patient’s safety following exposure to the study drug or in the judgement of the investigators will not be able to tolerate the procedure.
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
permuted block randomisation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/02/2008
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Actual
3/02/2010
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Date of last participant enrolment
Anticipated
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Actual
3/03/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
716
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New Zealand
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State/province [1]
716
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Auckland
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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A+ Trust fund
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Address [1]
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A+ Trust Office
Level 15
ACH Support Building
Private bag 92024
Auckland
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Country [1]
2920
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New Zealand
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Primary sponsor type
Hospital
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Name
A+ Trust fund
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Address
A+ Trust Office
Level 15
ACH Support Building
Private bag 92024
Auckland
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Country
New Zealand
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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 healthcare limited
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Address [1]
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33 Vestey Drive
Mt Wellington Auckland
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Country [1]
2637
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern X Regional Ethics Committee
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Ethics committee address [1]
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Ministry of Health 3rd Floor, Unisys Building 650 Great South Rd, Penrose Private bag 92522, Wellesley Street Auckland
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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09/10/2007
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Approval date [1]
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03/12/2007
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Ethics approval number [1]
4862
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NTX/07/10/103
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Summary
Brief summary
During peritoneal dialysis fluid is repeatedly recycled in the abdomen, to get rid of excess fluid and waste products. Peritonitis or infection of the lining inside the abdomen is a serious complication in dialysis patients that can sometimes result in death, hospitalisation or withdrawal of peritoneal dialysis. We add antibiotics to the dialysis fluid which then dwell inside the abdomen. The dialysis process interferes with the ability of the body to localise infection and depletes useful factors formed to fight it. Icodextrin® is a product that can provide superior dialysis to the traditional dextrose based product that is used in our units, especially so with fluid removal during peritonitis episodes. It is our aim to utilise the superior dialytic properties of Icodextrin® in the first 60 hours following a peritonitis episode with a dialysis free period of up to 12 hours to allow the body sufficient time to contain the infection and also to allow sufficient build up of the factors of immunity to overcome the infection. We want to show that this procedure is equivalent in safety to the traditional treatment we use and is associated with less inflammation in the peritoneum and blood of patients.
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Trial website
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Trial related presentations / publications
poster presentation International Society of peritoneal dialysis kuala Lumpur 09/09/2012 In Press . Peritoneal dialysis International
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Public notes
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Contacts
Principal investigator
Name
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Dr Maha Yehia
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Address
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Auckland City Hospital
Private Bag 92024
Auckland
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Country
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New Zealand
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Phone
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006421737276
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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. Maha Yehia
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Address
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Department of Renal Medicine
Level 15- support Building
Auckland City Hospital
Private Bag 92024
Auckland
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Country
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New Zealand
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Phone
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006421737276
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Fax
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006493074987
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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. Maha Yehia
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Address
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Department of Renal Medicine
Level 15- support Building
Auckland City Hospital
Private Bag 92024
Auckland
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Country
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New Zealand
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Phone
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006421737276
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Fax
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006493074987
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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
No additional documents have been identified.
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