- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01997385
The Clinical Effects of Korean Adapted APD in Automated Peritoneal Dialysis Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
It is well known that the efficiency of peritoneal dialysis (PD) varies with the duration of the dwell and the prescribed fill volume. Short dwell ensures adequate UF because the osmotic gradient is maintained while prolonged dwell allows for more solute clearance because the dialysate-to-plasma ratio (D/P) for uremic toxins such as creatinine and phosphate enhances. In terms of intraperitoneal fill volume, large fill volume improves the removal of uremic toxins for two reasons: a larger volume can be drained and therefore the clearance achieved is greater, and the peritoneal surface area available for the exchange is increased. Conversely, small fill volume promotes the process of UF because of the potentially low intraperitoneal pressure (IPP). Overall, choosing the optimal dwell time and exchange volume should promote UF and increase the removal of uremic toxins-urea in particular-to the dialysate.
Thus, this study proposes a new way of giving PD, using a modified version of conventional prescription which firstly uses 2 cycles of short dwell time with a small fill volume to promote UF and subsequently uses 2 cycles of longer dwell time and a larger fill volume to promote removal of uremic toxins from the blood.
Although it was already evaluated the efficiency of this modified prescription by Fischbach et al, the prescription currently prescribed in most Korean hospitals shows some differences in dwell time, fill volume and exchange cycling. The aim of this study is to assess the clinical effect of "Korean Adapted APD" (KAPD-A) compared to "Korean Conventional APD" (KAPD-C).
This is a multicenter, randomized, open-label, parallel controlled study. Patients who meet inclusion criteria will be randomized into each group at the ratio of 1:1. For incident patients, after being stable on APD and peritonitis-free at least 4 weeks, which is called as "run-in period", group 1 will start with 8 weeks of KAPD-C treatment and then cross over to 8 weeks of treatment with KAPD-A while group 2 will be performed on the contrary from KAPD-A to KAPD-C treatment.
Each patient will receive the same total amount of dialysate (8000 mL), given over the same 8-hour duration. First at the inclusion visit called "as baseline", and then visits will take place every 4 weeks for a total of 16 weeks.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
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Seoul, Korea, Republic of
- Samsung Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- End stage of Renal Disease(ESRD) patients with indication for renal replacement therapy
- D/P Creatinine above 0.5 as evaluated by a 4-hour peritoneal equilibration test(PET) at screening
- Stable on APD and peritonitis-free for at least 4 weeks(run-in phase) in case of incident patients who chose APD
- Peritonitis-free within 4 weeks in case of maintaining patients who treated with APD in current
- Written informed consent to study participation and data submission
Exclusion Criteria:
- Planned to kidney transplantation within 5 months
- Patients with ascites because of the progressed cirrhosis of the liver
- Suspected or confirmed pregnancy
- Prior enrolment in another clinical trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: KAPD-C
KAPD-C is a treatment prescribed 2000 mL fill volume per each 4 cycles of dialysis session with an exchange cycle of 90 minutes.
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KAPD-C is a treatment prescribed 2000 mL fill volume per each 4 cycles of dialysis session with an exchange cycle of 90 minutes.
|
Experimental: KAPD-A
KAPD-A is a treatment initially prescribed 1500 mL fill volume per each 2 cycles of dialysis session with an exchange cycle of 45 minutes and followed by 2 cycles of 2500 mL fill volume with an exchange cycle of 135 minutes.
|
KAPD-A is a treatment initially prescribed 1500 mL fill volume per each 2 cycles of dialysis session with an exchange cycle of 45 minutes and followed by 2 cycles of 2500 mL fill volume with an exchange cycle of 135 minutes.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Difference in overnight peritoneal ultrafiltration (UF) between KAPD-C and KAPD-A
Time Frame: at 4,8,12,16 weeks from baseline
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at 4,8,12,16 weeks from baseline
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Difference in weekly peritoneal Kt/V urea between KAPD-C and KAPD-A
Time Frame: at 4,8,12,16 weeks from baseline
|
at 4,8,12,16 weeks from baseline
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Difference in weekly peritoneal creatinine clearance between KAPD-C and KAPD-A
Time Frame: at 4,8,12,16 weeks from baseline
|
at 4,8,12,16 weeks from baseline
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Difference in phosphate dialytic removal between KAPD-C and KAPD-A
Time Frame: at 4,8,12,16 weeks from baseline
|
at 4,8,12,16 weeks from baseline
|
Difference in corrected for glucose absorption between KAPD-C and KAPD-A
Time Frame: at 4,8,12,16 weeks from baseline
|
at 4,8,12,16 weeks from baseline
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Daejoong Kim, Prof., Division of Nephrology, Samsung Medical Center
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- KAAPD_01_112013
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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