Relating Abdominal Complications With Peritoneal Pressure Estimation and Reporting

NCT ID: NCT06060951

Last Updated: 2023-09-29

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

UNKNOWN

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-10-01

Study Completion Date

2025-07-31

Brief Summary

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This is a prospective observational study in people treated with peritoneal dialysis for kidney failure to investigate whether estimated intraperitoneal pressure (eIPP) is correlated with non-infectious PD-related complications in end-stage renal failure patients. It looks to understand how both peritoneal dialysis complications (including fluid leaks and hernias) along with gastrointestinal symptoms are associated with eIPP in people treated with PD.

Detailed Description

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Peritoneal dialysis is an important treatment option for kidney failure. It involves the instillation of fluid into the peritoneal cavity. The choice of volume of fluid used has a limited evidence base but will be between 1 liter to 2.5 liters depending on clinical preference. The intraperitoneal pressure (IPP) that results from this fluid varies widely between patients. However, IPP is difficult to implement clinically. There is some evidence that higher IPP is associated with an increased rate of non-infectious PD complications. These complications are mainly leaks (escape of peritoneal fluid from the peritoneal cavity) and hernias.

New methods for estimating IPP (eIPP) have been recently developed but not validated clinically. This study looks to the association of eIPP and non-infectious PD complications as well as understanding whether there is an association between eIPP and patients' burden of symptoms.

This is an observational study, no changes to fill volume or treatment will result from the eIPP. Clinicians and nurses involved in the care of the patient will not receive feedback on the eIPP measurement. This simple study will look to recruiting patients with informed consent. Those who agree to enter the study will have a small number of non-invasive measurements made at the time of a routine clinic visit. A short survey will also be administered both at the initial visit, along with 3 and 12 months later. The research team, will review the patients' notes at 12 months following recruitment for evidence of non-infectious PD-related complications.

This research proposal has informed by interaction with people with lived experience. The scientific rationale has been tested by a discussion with experts in PD in other centres.

Given that this is an observational study, individuals will not be exposed to increased clinical risk through the alteration of PD fill volume or novel procedures. The greatest burden for participants will be the completion of three short, validated survey questionnaires over 12 months.

Confidentiality will be maintained with the use of pseudonymisation to maintain participants confidentiality.

Conditions

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Peritoneal Dialysis Kidney Failure, Chronic Hernia, Abdominal

Keywords

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Intraperitoneal pressure Gastrointestinal complications pleuroperitoneal fistulas patent processus vaginalis hernia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Incident cohort

Including all patients from the time of PD catheter insertion until 8 weeks after starting PD

Estimated intraperitoneal pressure

Intervention Type DIAGNOSTIC_TEST

The following anthropometric measurements are required:

1. Height: measured standing with shoes off
2. Weight: "dry weight" should be used
3. The distance from the decubitus plane to the mid-axillary line was measured
4. Waist circumference: measured with a tape measure wrapped above the iliac crests around the level of the umbilicus.

The estimated IPP will be assessed using different equations.

Prevalent cohort

Including all patients treated with PD who are greater than 8 weeks from the start of dialysis.

Estimated intraperitoneal pressure

Intervention Type DIAGNOSTIC_TEST

The following anthropometric measurements are required:

1. Height: measured standing with shoes off
2. Weight: "dry weight" should be used
3. The distance from the decubitus plane to the mid-axillary line was measured
4. Waist circumference: measured with a tape measure wrapped above the iliac crests around the level of the umbilicus.

The estimated IPP will be assessed using different equations.

Interventions

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Estimated intraperitoneal pressure

The following anthropometric measurements are required:

1. Height: measured standing with shoes off
2. Weight: "dry weight" should be used
3. The distance from the decubitus plane to the mid-axillary line was measured
4. Waist circumference: measured with a tape measure wrapped above the iliac crests around the level of the umbilicus.

The estimated IPP will be assessed using different equations.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older
* Diagnosis of end-stage renal failure requiring peritoneal dialysis as renal replacement therapy
* Ability to give informed consent and comply with study procedures.

Exclusion Criteria

* Known allergy or hypersensitivity to any component of the dialysis solution.
* Inability or unwillingness to comply with study procedures.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Imperial College Healthcare NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Richard Corbett, PhD

Role: PRINCIPAL_INVESTIGATOR

Imperial College Healthcare NHS Trust

Locations

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Birmingham Heartlands Hospital

Birmingham, , United Kingdom

Site Status

Hammersmith Hospital

London, , United Kingdom

Site Status

Countries

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United Kingdom

Central Contacts

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Richard Corbett, PhD

Role: CONTACT

Phone: +442033136647

Email: [email protected]

Ka Chun Leung, MRCP(UK)

Role: CONTACT

Phone: +447838907447

Email: [email protected]

Facility Contacts

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Jyoti Baharani, FRCP(UK)

Role: primary

Richard Corbett, PhD

Role: primary

Ka Chun Leung, MRCP(UK)

Role: backup

References

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Bello AK, Okpechi IG, Osman MA, Cho Y, Cullis B, Htay H, Jha V, Makusidi MA, McCulloch M, Shah N, Wainstein M, Johnson DW. Epidemiology of peritoneal dialysis outcomes. Nat Rev Nephrol. 2022 Dec;18(12):779-793. doi: 10.1038/s41581-022-00623-7. Epub 2022 Sep 16.

Reference Type BACKGROUND
PMID: 36114414 (View on PubMed)

Leblanc M, Ouimet D, Pichette V. Dialysate leaks in peritoneal dialysis. Semin Dial. 2001 Jan-Feb;14(1):50-4. doi: 10.1046/j.1525-139x.2001.00014.x.

Reference Type BACKGROUND
PMID: 11208040 (View on PubMed)

Chan R, Walker RJ, Samaranayaka A, Schollum J. Long-term impact of early non-infectious complications at the initiation of peritoneal dialysis. Perit Dial Int. 2023 Jan;43(1):53-63. doi: 10.1177/08968608221132647. Epub 2022 Nov 3.

Reference Type BACKGROUND
PMID: 36325812 (View on PubMed)

Outerelo MC, Gouveia R, Teixeira e Costa F, Ramos A. Intraperitoneal pressure has a prognostic impact on peritoneal dialysis patients. Perit Dial Int. 2014 Sep-Oct;34(6):652-4. doi: 10.3747/pdi.2012.00192. No abstract available.

Reference Type BACKGROUND
PMID: 25228214 (View on PubMed)

Fischbach M, Terzic J, Becmeur F, Lahlou A, Desprez P, Battouche D, Geisert J. Relationship between intraperitoneal hydrostatic pressure and dialysate volume in children on PD. Adv Perit Dial. 1996;12:330-4.

Reference Type BACKGROUND
PMID: 8865930 (View on PubMed)

Fischbach M, Desprez P, Donnars F, Geisert J. Hydrostatic intraperitoneal pressure in children on peritoneal dialysis: practical implications. An 18-month clinical experience. Adv Perit Dial. 1994;10:294-6.

Reference Type BACKGROUND
PMID: 7999848 (View on PubMed)

Castellanos LB, Clemente EP, Cabanas CB, Parra DM, Contador MB, Morera JCO, Daly JA. Clinical Relevance of Intraperitoneal Pressure in Peritoneal Dialysis Patients. Perit Dial Int. 2017 Sep-Oct;37(5):562-567. doi: 10.3747/pdi.2016.00267. Epub 2017 Jul 11.

Reference Type BACKGROUND
PMID: 28698250 (View on PubMed)

Scanziani R, Dozio B, Baragetti I, Maroni S. Intraperitoneal hydrostatic pressure and flow characteristics of peritoneal catheters in automated peritoneal dialysis. Nephrol Dial Transplant. 2003 Nov;18(11):2391-8. doi: 10.1093/ndt/gfg353.

Reference Type BACKGROUND
PMID: 14551372 (View on PubMed)

de Jesus Ventura M, Amato D, Correa-Rotter R, Paniagua R. Relationship between fill volume, intraperitoneal pressure, body size, and subjective discomfort perception in CAPD patients. Mexican Nephrology Collaborative Study Group. Perit Dial Int. 2000 Mar-Apr;20(2):188-93.

Reference Type BACKGROUND
PMID: 10809242 (View on PubMed)

Li X, Ma T, Hao J, Song D, Wang H, Liu T, Zhang Y, Abi N, Xu X, Zhang M, Sun W, Li X, Dong J. Novel equations for estimating intraperitoneal pressure among peritoneal dialysis patients. Clin Kidney J. 2023 Feb 2;16(9):1447-1456. doi: 10.1093/ckj/sfad021. eCollection 2023 Sep.

Reference Type BACKGROUND
PMID: 37664572 (View on PubMed)

Dejardin A, Robert A, Goffin E. Intraperitoneal pressure in PD patients: relationship to intraperitoneal volume, body size and PD-related complications. Nephrol Dial Transplant. 2007 May;22(5):1437-44. doi: 10.1093/ndt/gfl745. Epub 2007 Feb 17.

Reference Type BACKGROUND
PMID: 17308323 (View on PubMed)

Yi C, Wang X, Ye H, Lin J, Yang X. Patient-reported gastrointestinal symptoms in patients with peritoneal dialysis: the prevalence, influence factors and association with quality of life. BMC Nephrol. 2022 Mar 9;23(1):99. doi: 10.1186/s12882-022-02723-9.

Reference Type BACKGROUND
PMID: 35264119 (View on PubMed)

Durand PY, Chanliau J, Gamberoni J, Hestin D, Kessler M. Routine measurement of hydrostatic intraperitoneal pressure. Adv Perit Dial. 1992;8:108-12.

Reference Type BACKGROUND
PMID: 1361762 (View on PubMed)

Schmitt CP, Zaloszyc A, Schaefer B, Fischbach M. Peritoneal dialysis tailored to pediatric needs. Int J Nephrol. 2011;2011:940267. doi: 10.4061/2011/940267. Epub 2011 Jun 8.

Reference Type BACKGROUND
PMID: 21761001 (View on PubMed)

Du BOIS D, Du BOIS EF. CLINICAL CALORIMETRY: TENTH PAPER A FORMULA TO ESTIMATE THE APPROXIMATE SURFACE AREA IF HEIGHT AND WEIGHT BE KNOWN. Archives of Internal Medicine. 1916;XVII(6_2): 863-871. https://doi.org/10.1001/archinte.1916.00080130010002

Reference Type BACKGROUND

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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326995

Identifier Type: OTHER

Identifier Source: secondary_id

23HH8380

Identifier Type: -

Identifier Source: org_study_id