Comparison of MCO HD on Markers of Vascular Health Compared With On-Line Haemodiafiltration

NCT ID: NCT03510520

Last Updated: 2019-08-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-14

Study Completion Date

2019-05-09

Brief Summary

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The aim of this study is to evaluate haemodialysis treatment using a medium cut-off dialysis membrane (Theranova) compared with on-line haemodiafiltration treatment with respect to markers of endothelial health (plasma endothelial microvesicle levels, pro-inflammatory and pro-coagulant markers).

This study will also compare the 2 treatment modalities with respect to several other outcome measures including patient-reported outcome measures, haemodynamic parameters and advanced glycation end-products.

Detailed Description

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To date, methods of improving outcomes for haemodialysis patients have focused on improving small molecule clearance (urea); however, the benefits do not appear to be linear and increasing Kt/V above 1.3 shows no benefit. Current dialysis therapies are unable to provide effective clearance of larger "middle molecules" (between 20kDa and 60kDa) and retention of these molecules may be linked to poor outcomes in haemodialysis patients.

Medium cut-off (MCO) dialysis membranes have been recently developed to address this area of unmet need and provide an enhanced clearance of some larger middle molecules when compared with high flux haemodialysis (HFHD) and even high volume haemodiafiltration (HDF). The clinical benefit of this therapy is yet to be defined.

The aim of this study is to investigate the effect of HDx therapy (expanded haemodialysis therapy through the use of a MCO haemodialysis membrane- Theranova) on vascular endothelial and inflammatory biomarkers compared with high volume HDF therapy. Through the use of endothelial microvesicles (EMV) as a marker of vascular endothelial health, which strongly correlate with cardiovascular outcomes in end-stage real disease (ESRD) patients, this pilot study will take the first steps into exploring whether HDx treatment provides clinical benefits in addition to its simplicity of implementation. Additionally, other important parameters, such as dialysis recovery time, patient-reported outcome measures and volume management will also be explored and compared with high volume HDF.

Conditions

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End Stage Renal Disease Cardiovascular Diseases Inflammation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a single-centre, pilot, open-label, interventional, randomised controlled study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Medium Cut-Off Haemodialysis (Theranova)

Participants will receive medium cut-off haemodialysis treatment for 6 months in total (3 times per week treatment).

Group Type EXPERIMENTAL

Medium Cut-Off Haemodialysis

Intervention Type DEVICE

Treatment with medium cut-off haemodialysis using the Theranova dialysis membrane 3 times per week for 6 months

On-Line Haemodiafiltration

Participant will remain on their usual on-line haemodiafiltration (HDF) treatment for the 6 month study duration (3 times per week treatment).

Group Type ACTIVE_COMPARATOR

On-Line Haemodiafiltration

Intervention Type DEVICE

Treatment with on-line haemodiafiltration (HDF) 3 times per week for 6 months (Conventional treatment)

Interventions

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Medium Cut-Off Haemodialysis

Treatment with medium cut-off haemodialysis using the Theranova dialysis membrane 3 times per week for 6 months

Intervention Type DEVICE

On-Line Haemodiafiltration

Treatment with on-line haemodiafiltration (HDF) 3 times per week for 6 months (Conventional treatment)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Established on in-centre haemodiafiltration (HDF) for greater than 12 weeks with a minimum of 3 treatment sessions per week
* Ability to consent

Exclusion Criteria

* Planned live donor renal transplant within 6 months (with confirmed date)
* Planned switch in renal replacement modality (ie. to peritoneal dialysis or home haemodialysis)
* Clinician predicted prognosis \< 6 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Manchester Metropolitan University

OTHER

Sponsor Role collaborator

Baxter Healthcare Corporation

INDUSTRY

Sponsor Role collaborator

Manchester University NHS Foundation Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sandip Mitra, MBBS

Role: PRINCIPAL_INVESTIGATOR

Manchester University NHS Foundation Trust

Locations

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Manchester NHS Foundation Trust

Manchester, Lancashire, United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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R04863

Identifier Type: -

Identifier Source: org_study_id

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