- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02769351
Global rEgistry on decongestioN Therapy Using Less invasivE UltraFiltration (GENTLE-UF)
July 12, 2021 updated by: Fresenius Medical Care Deutschland GmbH
A Multicentre, Prospective Registry to Evaluate the Safety and Efficacy of Minimally Invasive Ultrafiltration Treatment and Its Effect on Symptoms and Rehospitalisation in Patients With Advanced Volume Overload
In patients with advanced volume overload, minimally invasive ultrafiltration treatment in the acute phase can have a positive effect on clinical outcome.
The aim is to collect treatment data in the context of a prospective registry of the safety and performance of minimally invasive ultrafiltration.
The data will be recorded via an electronic case report form (eCRF); the eCRF runs on a server located in Germany and complies with current data protection regulations.
It is intended to include about 300-500 patients with advanced volume overload at a minimum of 10 sites.
In addition, data on a disease management programme (in-body measurement and home monitoring) will be recorded in up to 40 of these patients.
The treatment data from each patient will be recorded over 12 months.
An interim analysis will be performed after 150 patients have been observed for 6 months.
The knowledge about ultrafiltration in volume overload obtained from the registry, in some cases in combination with a disease management programme, is intended to improve the body of evidence.
In addition, the data will be used for hypothesis generation.
Study Overview
Status
Terminated
Intervention / Treatment
Detailed Description
There may be various reasons why an increased accumulation of fluid occurs in tissue.
The most common causes include heart failure, kidney failure or cirrhosis of the liver.
In rare cases, oedema can develop following septicaemia.
The usual treatment of oedema involves diuretics, i.e. water tablets, which remove excess fluid from the body and which can be administered either orally or intravenously.
For some years now, it has also been possible to use ultrafiltration to treat oedema.
This involves filtering and removing excess fluid from the blood.
This individual method enables a precisely defined amount of fluid to be withdrawn.
Access to the blood circulation is usually via a central venous catheter, as in acute dialysis.
Current international treatment guidelines recommend that consideration should be given to ultrafiltration therapy in the context of treatment of diuretic-resistant volume overload (e.g.
second- or third-line therapy for acute decompensated heart failure).
There are, however, to date no clinical data on a combined treatment regimen of diuretics and supportive ultrafiltration.
Accordingly, ultrafiltration may be included in clinical guidelines either only with a low level of evidence (e.g.
IIb in the ACCF/AHA guidelines) or not at all (ESC guidelines).
The main reasons for the limited body of evidence for ultrafiltration are, on the one hand, the invasive nature of the usual procedures (these usually require the insertion of a central venous catheter) and structural barriers in the health system (ultrafiltration is normally offered by nephrologists and not by cardiologists).
With an increasing clinical need and limited medical alternatives, particularly in view of the frequently occurring diuretic resistance in heart failure, there is an urgent medical need to fill this gap in evaluation evidence.
In the context of the registry, the CHIARA system, a minimally invasive (i.e. via a peripheral venous access) extracorporeal ultrafiltration system, is used for the treatment of decompensated volume overload.
The CHIARA system has a CE mark for the intended purpose of ultrafiltration of the blood of patients suffering from heart failure, acute or chronic renal failure or excess body fluid.
It is planned to use the medical device in connection with this intended purpose only.
In participating hospitals, patients will be treated with this new treatment strategy of minimally invasive ultrafiltration treatment in support of diuretic drug therapy in the acute phase of volume overload.
It is possible with the use of ultrafiltration therapy to control volume overload and reduce it on an individual basis, so that diuretics can be given sparingly and, as a consequence, diuretic resistance and a deterioration of renal function due to diuretic uptitration can be avoided.
Study Type
Observational
Enrollment (Actual)
104
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Berlin, Germany, 13125
- Helios Klinikum Berlin Buch
-
-
Baden Württemberg
-
Heidelberg, Baden Württemberg, Germany, 69120
- UniversitatsKlinikum Heidelberg
-
Stuttgart, Baden Württemberg, Germany, 70174
- Klinikum Stuttgart
-
-
Baden- Württemberg
-
Karlsruhe, Baden- Württemberg, Germany, 76185
- Helios Klinik für Herzchirurgie GmbH Karlsruhe
-
-
Baden-Württemberg
-
Mannheim, Baden-Württemberg, Germany, 68167
- Universitätsklinikum Mannheim
-
-
Niedersachsen
-
Braunschweig, Niedersachsen, Germany, 38126
- Städtisches Klinikum Braunschweig
-
Hildesheim, Niedersachsen, Germany, 31135
- Helios Klinikum Hildesheim
-
-
Nordrhein-Westfalen
-
Attendorn, Nordrhein-Westfalen, Germany, 57439
- Helios Klinik Attendorn
-
-
North Rhine-Westphalia
-
Aachen, North Rhine-Westphalia, Germany, 52074
- Uniklinik RWTH Aachen
-
Duisburg, North Rhine-Westphalia, Germany, 47053
- Helios Klinikum Duisburg
-
-
Thueringen
-
Erfurt, Thueringen, Germany, 99089
- Helios Klinikum Erfurt
-
-
-
-
-
Falun, Sweden, 79182
- Falun hospital
-
Malmö, Sweden, 20502
- SUS Skanes University Hosptal
-
Stockholm, Sweden, 17176
- Karolinska University Hospital
-
Stockholm, Sweden, 18288
- Danderyd University Hospital
-
Uppsala, Sweden, 75185
- Uppsala University Hospital
-
Örebro, Sweden, 70185
- University hospital Örebro
-
-
-
-
-
Aarau, Switzerland, 5001
- Kantonsspital Aarau
-
Zurich, Switzerland, 8091
- Universitätsspital Zürich
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Probability Sample
Study Population
Patients treated with minimally invasive ultrafiltration in support of diuretic drug therapy in the acute phase of volume overload.
Description
Inclusion Criteria:
- ≥18 years
- Inpatient-treated patients with acute volume overload, preferably in association with cardiac decompensation with signs of incipient diuretic resistance (lack of increase in urine output despite significant escalation of diuretic therapy; e.g. ≥80 mg furosemide / 24 h or less than 1375 mL urine output/40 mg furosemide per 24 h or equivalent dose of other loop diuretics [established clinically or from the medical history])
- New York Association Functional Class (NYHA) III-IV at inclusion
- Systolic or diastolic cardiac dysfunction (HF-REF or HF-PEF)
- Adequate venous access (preferably peripheral arm vein) allowing a flow rate ≥ 60 mL / min
- Written consent to the use of data in the registry (where necessary, by a legal guardian).
Exclusion Criteria:
- Contraindication to anticoagulation (e.g. known heparin-induced thrombocytopenia, severe bleeding)
- Terminal renal failure (stage V, GFR <15 mL)
- Cardiogenic shock, e.g. in association with acute coronary syndrome (ACS)
- Other diseases or factors that, in the study doctor's opinion, constitute a potential contraindication to ultrafiltration
- Pregnant women, women in labour, breast-feeding women or women of childbearing potential, who are without adequate contraception or are planning a family. NB: a pregnancy test is performed systematically in women of childbearing age and the patient is not included in the event of pregnancy (positive test). It is absolutely essential that women, who have a negative test and who are included in the study, have an effective contraception.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
periph. minimal invasive ultrafiltration
Patients with volume overload receiving ultrafiltration
|
ultrafiltration via a peripheral single-needle
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rehospitalisation (Yes/no) Due to Exacerbation of Heart Failure/Volume Overload of Other Origin
Time Frame: 12 months
|
The number of rehospitalizations due to heart failure resp.
volume overload has been measured as a clinical endpoint and analyzed based on the AP.
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Significant Deterioration of Kidney Function - Creatinine
Time Frame: Recruitment; Discharge from Index Hospitalization; Outpatient visit I (3-9 months); Outpatient visit II ( 12 months)
|
Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP.
The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).
|
Recruitment; Discharge from Index Hospitalization; Outpatient visit I (3-9 months); Outpatient visit II ( 12 months)
|
Significant Deterioration of Kidney Function - Urea
Time Frame: Recruitment; Discharge from Index Hospitalization; Outpatient visit I (3-6 months); Outpatient visit II (12 months)
|
Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP.
The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).
|
Recruitment; Discharge from Index Hospitalization; Outpatient visit I (3-6 months); Outpatient visit II (12 months)
|
Significant Deterioration of Kidney Function - eGFR (Estimated Glomerular Filtration Rate)
Time Frame: Recruitment, Discharge from index hospitalization, Outapteint visit I (3-6 months), Outpatient visit II (12 months)
|
Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP.
The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).
|
Recruitment, Discharge from index hospitalization, Outapteint visit I (3-6 months), Outpatient visit II (12 months)
|
Significant Deterioration of Kidney Function - Cystatin
Time Frame: recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months), Outpatient visit II (12 months)
|
Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP.
The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).
|
recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months), Outpatient visit II (12 months)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Henning T Baberg, MD, Helios Klinikum Berlin Buch, Berlin
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239. doi: 10.1016/j.jacc.2013.05.019. Epub 2013 Jun 5. No abstract available.
- McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Kober L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Ronnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A; Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology; Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, McDonagh T, Sechtem U, Bonet LA, Avraamides P, Ben Lamin HA, Brignole M, Coca A, Cowburn P, Dargie H, Elliott P, Flachskampf FA, Guida GF, Hardman S, Iung B, Merkely B, Mueller C, Nanas JN, Nielsen OW, Orn S, Parissis JT, Ponikowski P; ESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012 Aug;14(8):803-69. doi: 10.1093/eurjhf/hfs105. No abstract available. Erratum In: Eur J Heart Fail. 2013 Mar;15(3):361-2.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
December 3, 2015
Primary Completion (ACTUAL)
March 4, 2019
Study Completion (ACTUAL)
March 4, 2019
Study Registration Dates
First Submitted
March 21, 2016
First Submitted That Met QC Criteria
May 10, 2016
First Posted (ESTIMATE)
May 11, 2016
Study Record Updates
Last Update Posted (ACTUAL)
August 5, 2021
Last Update Submitted That Met QC Criteria
July 12, 2021
Last Verified
April 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UF-HF-01-INT
- DRKS00009836 (REGISTRY: DRKS: German Clinical Trials Register)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
Overall results will be published.
Individual participant data will not be made available.
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.
Clinical Trials on Acute Heart Failure
-
Idorsia Pharmaceuticals Ltd.CompletedAcute Heart Failure | Acute Decompensation of Chronic Heart Failure | New Onset of Heart FailureUnited States, United Kingdom, Israel, Switzerland, Austria, Denmark, France, Germany, Greece, Poland
-
Idorsia Pharmaceuticals Ltd.CompletedAcute Heart Failure | Acute Decompensation of Chronic Heart Failure | New Onset of Heart FailureUnited States, Hungary, Australia, Czechia, Germany, Italy, Norway, United Kingdom
-
Abiomed Inc.RecruitingHeart Diseases | Acute Decompensated Heart Failure | Congestive Heart Failure | Acute Heart FailureUnited States
-
Shanghai Chest HospitalUnknownAcute Renal Failure | Acute Heart FailureChina
-
Magenta Medical Ltd.TerminatedCongestive Heart Failure | Heart Failure, Congestive | Acute Heart FailureCroatia, Belgium, Serbia
-
University Medical Center GroningenCompletedHeart Failure; With Decompensation | Heart Failure,Congestive | Heart Failure AcuteNetherlands
-
University Hospital, Clermont-FerrandHospices Civils de Lyon; University Hospital, Grenoble; Hôpital de la Croix-Rousse and other collaboratorsRecruitingHeart Failure | Chronic Heart Failure | Acute Heart FailureFrance
-
Jordan Cardio Vascular Research GroupRecruitingHeart Failure | Chronic Heart Failure | Acute Heart FailureJordan
-
Azienda Ospedaliera Città della Salute e della...Caretek S.r.l. Turin, Italy; Santer Reply S.p.A. Milan, ItalyUnknownHeart Failure; With Decompensation | Heart Failure,Congestive | Heart Failure AcuteItaly
-
Clinica Alemana de SantiagoNot yet recruitingDecompensated Heart Failure | Heart Failure Acute
Clinical Trials on periph. minimal invasive ultrafiltration
-
Norwegian University of Science and TechnologySt. Olavs HospitalCompleted
-
UMC UtrechtUnknownCoronary Artery Disease | Myocardium; InjuryNetherlands
-
Jeder GmbHUnknownInsufficient Bone Mass in the Maxilla for Dental ImplantsAustria
-
Goorens Chul KiRecruitingRadius Fracture DistalBelgium
-
Peking Union Medical College HospitalBeijing Municipal Health CommissionRecruiting
-
Peking University People's HospitalUnknownNon-small Cell Lung CancerChina
-
The University of Texas Medical Branch, GalvestonCompletedLower Urinary Tract Symptoms | Lower Gastrointestinal Tract Symptoms
-
Assiut UniversityNot yet recruitingEsophageal Diseases | Esophagostomy Complication
-
Katleen JOTTARDCompletedPudendopathie | ClunealgieBelgium
-
Region Örebro CountyUnknownKnee OsteoarthritisSweden