Assessment of Bioimpedance and Vitamin D and LV Mass in PD Patients (FLUID Study) (FLUID)
The Effect of Bio-impedance Analysis and Vitamin D Versus Usual Care on Left Ventricular Mass in Peritoneal Dialysis Patients: a Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Patients on peritoneal dialysis are frequently hypervolemic which is associated with deleterious changes in left ventricular (LV) architecture including increased LV mass. In dialysis patients, increased LV mass is associated with death. Recent randomized trials have demonstrated that increasing small solute clearance is not associated with improved outcomes - hence an increased interest in the management of volume control in ESRD patients. Bioimpedance analysis is inexpensive, safe and easy to use and appears to be more useful than other techniques to assess volume status in dialysis patients. In addition, dialysis patients are vitamin D deficient and this is also associated with an increased LV mass and its inherent complications.
This study will evaluate the use of bioimpedance analysis versus usual care to assess and manage volume status and the use of vitamin D versus placebo in peritoneal dialysis patients and its effect on LV mass as measured by cardiac MRI.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Dr. Azim S Gangji, MD MSc FRCPC
- Phone Number: 33261 9055221155
- Email: gangji@mcmaster.ca
Study Locations
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-
Ontario
-
Hamilton, Ontario, Canada, L8N4A6
- St. Joseph's Healthcare Hamilton
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Hamilton, Ontario, Canada
- Population Health Research Institute - McMaster University
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18 years
- on peritoneal dialysis
Exclusion Criteria:
- Contraindication to MRI including presence of a pacemaker, defibrillator, ferromagnetic cerebral aneurysm clips, cochlear implants or eye prosthesis, neurostimulators, shrapnel in vital locations, surgery within 6 weeks, severe claustrophobia and severe obesity
- Previous amputation
- Life or technique expectancy < 1 year
- Pregnancy
- Peritonitis in previous 3 months
- Currently using more than one extraneal bag per 24-hours
- Known icodextrin allergy
- Currently using non-Baxter PD solutions
- Inability to provide consent
- Allergy to cholecalciferol
- Serum Calcium > 2.55 mmol/L
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Bioimpedance and Vitamin D
|
Intervention subjects will undergo BIA assessment monthly for 1 year, and then every 3 months until the end of the planned 3-year study.
Protocolized interventions to achieve euvolemia will occur based on the BIA result and they include sodium restriction, addition of diuretics, use of icodextrin, and additional rational changes to the PD prescription.
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|
Experimental: Usual care and Vitamin D
Usual Care and Vitamin D3
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Usual care (not bioimpedance guided volume management) and Vitamin D
|
|
Experimental: Bioimpedance and Placebo
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Bioimpedance guided volume management and Placebo
|
|
Placebo Comparator: Usual Care and Placebo
|
Usual care (not bioimpedance guided volume management) and Placebo
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Left ventricular mass measured by cardiac MRI
Time Frame: 1 year
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Combined outcome of death, non-fatal CV event (stroke, MI, amputation, CHF), and transfer to HD for inadequacy or ultrafiltration failure
Time Frame: 3 years
|
3 years
|
|
Volume measures: bio-impedance (RXc graph, vector length, impedance ratio, phase angle, ECW:TBW ratio), weight, N-BNP, mean and pulse arterial pressure, number of anti-hypertensive agents
Time Frame: 3 years
|
3 years
|
|
Health-related quality of life (HRQOL)
Time Frame: 1 year
|
1 year
|
|
Physical function as measured by 6 minute walk test
Time Frame: 1 year
|
1 year
|
|
Serum and peritoneal inflammatory and fibrotic markers: albumin, CRP, IL-6, TNF-a
Time Frame: 1 year
|
1 year
|
|
Peritoneal membrane transport properties,measured by PET
Time Frame: 3 years
|
3 years
|
|
Renal and peritoneal solute clearance, 24-hour urine output and ultrafiltration volume
Time Frame: 3 years
|
3 years
|
|
left ventricular end-diastolic and systolic volumes, stroke volume and ejection fraction measure by MRI
Time Frame: 1 year
|
1 year
|
|
Fraility Score
Time Frame: 1 year
|
1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Azim S Gangji, MD MSc FRCPC, St. Joseph's Healthcare Hamilton
- Principal Investigator: K S Brimble, MD MSc FRCPC, St. Joseph's Healthcare Hamilton
Publications and helpful links
General Publications
- Brimble KS, Ganame J, Margetts P, Jain A, Perl J, Walsh M, Bosch J, Yusuf S, Beshay S, Su W, Zimmerman D, Lee SF, Gangji AS. Impact of Bioelectrical Impedance-Guided Fluid Management and Vitamin D Supplementation on Left Ventricular Mass in Patients Receiving Peritoneal Dialysis: A Randomized Controlled Trial. Am J Kidney Dis. 2022 Jun;79(6):820-831. doi: 10.1053/j.ajkd.2021.08.022. Epub 2021 Oct 14.
- Su WS, Gangji AS, Margetts PM, Bosch J, Yusuf S, Clase CM, Ganame J, Noseworthy M, Lonn E, Jain AK, McCormick B, Brimble KS. The fluid study protocol: a randomized controlled study on the effects of bioimpedance analysis and vitamin D on left ventricular mass in peritoneal dialysis patients. Perit Dial Int. 2011 Sep-Oct;31(5):529-36. doi: 10.3747/pdi.2010.00232. Epub 2011 May 31.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SJH-Renal-RCT-003
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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