Interdialytic Peritoneal UltraFiltration in HemoDialysis Patients

Phase

Condition

Hemodialysis

Treatment

Interdialytic peritoneal ultrafiltration with 10% dextrose solution

Clinical Study ID

NCT04603014

115423

Ages > 18
All Genders

Study Summary

Sodium accumulates in the tissues of patients with kidney disease and impairs survival. Three-times weekly, standard hemodialysis alone cannot remove excess sodium efficiently. A sample of 10 chronic hemodialysis patients will undergo a 5-week, pilot, interventional study to test the efficacy of additional sodium removal in-between hemodialysis sessions, twice per week, for three weeks. Tissue sodium removal will be achieved with peritoneal dialysis after the surgical insertion of a peritoneal dialysis catheter. Tissue sodium removal will be assessed at the beginning and at the end of the study with sodium magnetic resonance imaging of a peripheral limb (leg). Patients will also undergo monitoring for symptoms and blood pressure throughout the study to assess the safety of this procedure.

Eligibility Criteria

Inclusion

Inclusion Criteria

At least one of the following:
Average per-session interdialytic weight gain ≥ 4.0 % of their dry weight in the last month;
Inability to consistently achieve dry weight with the current treatment schedule;
Need for additional HD treatments to achieve prescribed dry weight.
Weekly HD sessions - up to three times/week
Age ≥18 years
Willing and able to give informed consent

Exclusion Criteria

Contraindications to peritoneal dialysis
Contraindications to MRI
Uncontrolled diabetes mellitus
Active infections
Non-compliance to hemodialysis prescription
Pre-study serum sodium < 130 mmol/L

Study Design

Interdialytic peritoneal ultrafiltration with 10% dextrose solution

January 01, 2021

December 30, 2025

Study Description

Hypothesis: Interdialytic peritoneal ultrafiltration (iPUF) via Tenckhoff peritoneal dialysis catheter using 10% Dextrose infusate is feasible and provides effective volume management and sodium removal in prevalent HD patients.

Overview: This is a prospective, interventional pilot study from the London Health Sciences Centre (LHSC) prevalent HD population. Study patients will undergo the surgical implantation of a Tenckhoff peritoneal dialysis catheter before study start. After the successful insertion of the Tenckhoff catheter, study patients will enter a run-in phase, where their residual renal function, volume, hemodynamic and cardiac status during HD will be assessed. During the following weeks (intervention weeks 1, 2, 3), study patients will receive in-center iPUF intervention, consisting of peritoneal infusate instillation of a 10% dextrose solution via a Tenckhoff catheter, immediately after the first two HD sessions of the week (Monday, Wednesday); the infusate will be dwelling in the study patient's peritoneal cavity for 2 hours, at the end of which the solution will be drained and the patient sent home. Study patients will be monitored during infusate administration and for the first four hours thereafter. The study intervention will be discontinued at the beginning of week 5 (Wash-out); during week 5 and the first HD session of week 6, study patients will be monitored to observe potential residual effects of the iPUF intervention.

Connect with a study center

London Health Sciences Centre
London, Ontario N6A 5W9
Canada
Site Not Available
London Health Sciences Centre
London 6058560, Ontario 6093943 N6A 5W9
Canada
Site Not Available

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