Peritoneal Dialysis in Congestive Heart Failure (PDinCHF)
Symptomatic Improvement by Peritoneal Dialysis in Patients With End Stage Congestive Heart Failure
Rationale: End-stage congestive heart failure is a serious invalidating condition with a poor prognosis and increasing incidence. Non-randomized observations showed peritoneal dialysis (PD) in these patients to improve clinically from NYHA stadium III-IV to as low as NYHA stadium I-II. A randomized trial is needed to test whether PD improves symptoms in this condition and to find an optimal scheme.
Objective: To improve symptomatology in severe chronic failure patients. Study design: Open, parallel intervention trial comparing 2 schemes of peritoneal dialysis with icodextrin (Extraneal®) with standard medical therapy..
Study population: Patients with chronic refractory left ventricular congestive heart failure (LVEF < 30%, older than 18 years).
Intervention: Peritoneal dialysis with one (night) or two (night and day) dwells with icodextrin (Extraneal®).
Main study parameters/endpoints: Reduction in NYHA classification of symptomatic Congestive Heart Failure at 8 months after start of PD therapy. Burden of congestive heart failure: measured by reduction in unfavorable days (noted by patients in diaries and including days of hospitalization for CHF-deterioration and death).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
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Groningen, Netherlands, 9700 RM
- Martini Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > 18 years
- Refractory Left Ventricular Congestive Heart Failure: LVEF < 30%
- Diminished renal function: eGFR < 60 ml/min
- Clinically volume overloaded (Dyspnoea (NYHA III-IV), edema, and/or ascites)
- Hospitalization for CHF during the last 6 months
- Patient is on optimal cardiologic medical therapy, which has been stable for more than 4 weeks
- Suitable for PD
Exclusion Criteria:
- Hypotension (SBP < 100 mmHg / MAP < 70) mmHg
- Instable AP or recent (< 6 months) myocardial infarction.
- Contraindications for PD (e.g. visual handicap, social)
- Liver failure
- COPD Gold class IV
- Malignancy with life expectancy < 2 years
- Non compliance
- No informed consent
- Poor mental health
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Sham Comparator: Standard Care
|
2000 ml icodextrin intraperitoneally one or two times a day.
Dose will be adapted clinically as in standard peritoneal dialysis.
Other Names:
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|
Active Comparator: 2 Icodextrin PD changes / day
|
2000 ml icodextrin intraperitoneally one or two times a day.
Dose will be adapted clinically as in standard peritoneal dialysis.
Other Names:
|
|
Active Comparator: 1 Icodextrin PD change/day
|
2000 ml icodextrin intraperitoneally one or two times a day.
Dose will be adapted clinically as in standard peritoneal dialysis.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Number of patients in NYHA class I, II, III, or IV as measure of quality of life
Time Frame: 8 months
|
8 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Quality of life measures
Time Frame: 8 months
|
Reduction in unfavorable days.
Short-Form 36.
Minnesota Living with Heart failure Questionnaire.
6 minute walk test.
(re)hospitalization.
Survival.
Medication optimalisation.
Cardial: LVH.
Renal: GFR/ERPF/FF; KIM-1, NGAL, NAG.
Volume status: ECV (radioactive and bio-impedance).
Neurohumoral and inflammatory parameters.
|
8 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Wilbert M Janssen, MD, PhD, Martini Hospital
Study record dates
Study Major Dates
Study Start
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 (Estimate)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- PDinCHF
- 2009-017711-15 (EudraCT Number)
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