INCremental Dialysis to Improve Health Outcomes in People Starting Haemodialysis (INCH-HD)

NCT ID: NCT04932148

Last Updated: 2024-04-18

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

RECRUITING

Clinical Phase

NA

Total Enrollment

372 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-06

Study Completion Date

2026-08-31

Brief Summary

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The INCH-HD trial will test if incremental HD preserves the quality of life of patients and families and is a safe, practical, cost effective treatment option.

Detailed Description

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Kidney failure is a growing public health problem and fatal unless treated with dialysis or transplantation. Haemodialysis is the most common treatment for kidney failure in Australia and globally. Patients find haemodialysis extremely burdensome due to symptoms like fatigue, pain, cramps and poor quality of life that generally equates to \<60% of full health. Furthermore, haemodialysis is associated with an extremely high mortality (\<50% survive 5 years), particularly in the first 3-6 months of starting haemodialysis, which is likely linked to the rapid loss of patients' own kidney function when starting haemodialysis abruptly at three sessions/week. Observational studies suggest that starting haemodialysis incrementally at two sessions/ week is associated with lower mortality and better preservation of patients' remaining kidney function while offering many patient-important advantages, including dialysis free time and ability to work. However, robust evidence to recommend this incremental approach is lacking.

The INCH-HD study is an investigator-initiated, international, multicentre, prospective, adaptive, randomised, open-label, parallel group, non-inferiority trial. The primary objective of the study is to demonstrate whether incremental HD is non-inferior to conventional HD for the patient-important outcome of quality of life measured using Kidney-specific component of the Kidney Disease Quality of Life - Short Form measurement (KDQOL-SF) at 6 months from dialysis commencement.

The study will recruit a total of 372 participants across HD centres in Australia, and Canada. The outcomes of this trial will will provide urgently needed high quality evidence on whether starting haemodialysis incrementally at two sessions/week compared to the conventional three sessions/week can safely reduce the physical, financial and quality-of life burden on patients, lower early mortality rates and slow loss of kidney function while increasing haemodialysis capacity and reducing costs.

Conditions

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Kidney Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Incremental HD

Participants randomised to incremental HD will commence HD twice weekly and continue until an indication for an increase to three sessions/week (trigger point) is reached.

Group Type EXPERIMENTAL

Incremental HD

Intervention Type OTHER

Starting haemodialysis at twice weekly frequency

Conventional HD

Participants randomised to conventional HD will commence HD thrice weekly from the first HD session.

Group Type OTHER

Conventional HD

Intervention Type OTHER

Starting haemodialysis at thrice weekly frequency

Interventions

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Incremental HD

Starting haemodialysis at twice weekly frequency

Intervention Type OTHER

Conventional HD

Starting haemodialysis at thrice weekly frequency

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Adults (≥ 18 years of age) and
2. Commencing HD as their initial dialysis therapy and
3. Able to give informed consent

Exclusion Criteria

1. Urine output \<0.5Litres/day
2. Unlikely to be on HD for ≥1 year.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical Research Future Fund

OTHER

Sponsor Role collaborator

Queensland Health

OTHER_GOV

Sponsor Role collaborator

Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

The University of Queensland

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter Kerr, Prof

Role: PRINCIPAL_INVESTIGATOR

University of Queensland, Monash University

David Johnson, Prof

Role: PRINCIPAL_INVESTIGATOR

University of Queensland, Queensland Health

Andrea Viecelli, Dr

Role: PRINCIPAL_INVESTIGATOR

University of Queensland, Queensland Health

Charmaine Lok, Prof

Role: PRINCIPAL_INVESTIGATOR

University Health Network, Toronto

Locations

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Concord Repatriation General Hospital

Concord, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Northern Beaches Hospital

Frenchs Forest, New South Wales, Australia

Site Status NOT_YET_RECRUITING

St George Hospital

Kogarah, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Liverpool Hospital

Liverpool, New South Wales, Australia

Site Status NOT_YET_RECRUITING

John Hunter Hospital

New Lambton Heights, New South Wales, Australia

Site Status RECRUITING

Royal North Shore Hospital

Saint Leonards, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Bundaberg Hospital

Bundaberg, Queensland, Australia

Site Status NOT_YET_RECRUITING

Cairns Hospital

Cairns, Queensland, Australia

Site Status RECRUITING

Redland Hospital

Cleveland, Queensland, Australia

Site Status NOT_YET_RECRUITING

Logan Hospital

Logan City, Queensland, Australia

Site Status RECRUITING

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status RECRUITING

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status NOT_YET_RECRUITING

Monash Health

Melbourne, Victoria, Australia

Site Status NOT_YET_RECRUITING

Eastern Health

Melbourne, Victoria, Australia

Site Status NOT_YET_RECRUITING

Fiona Stanley Hospital

Murdoch, Western Australia, Australia

Site Status NOT_YET_RECRUITING

University Health Network- University of Toronto

Toronto, Ontario, Canada

Site Status NOT_YET_RECRUITING

Countries

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Australia Canada

Central Contacts

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Ruth Stastny

Role: CONTACT

+61 417 690 237

Facility Contacts

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Shaundeep Sen, Dr

Role: primary

02 9767 6447

John-Paul Killen

Role: primary

Brendan Smyth

Role: primary

Angela Makris, Dr

Role: primary

Denise Jones

Role: primary

02 4921 4332

Melissa Mulholland

Role: backup

02 4921 4332

Emma O'Lone, Dr

Role: primary

Clyson Mutatiri, Dr

Role: primary

Chetana Naresh, Dr

Role: primary

David Mudge, Dr

Role: primary

Vinod Khelgi, Dr

Role: primary

Andrea Viecelli, Dr

Role: primary

Randall Faull, PI

Role: primary

Bronwyn Hockley, SC

Role: backup

08 - 7074 3077

Peter Kerr

Role: primary

Matthew Roberts

Role: primary

Ramyasuda Swaminathan

Role: primary

Charmaine Lok

Role: primary

Other Identifiers

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AKTN 20.04

Identifier Type: -

Identifier Source: org_study_id

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