- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03065972
Hemodialysis in the Elderly (70yrs & Older) (ELDERLY)
A Randomized Controlled Comparative Study on Efficacy and Cost-effectiveness of Autologous Arteriovenous Fistulas Versus Hemodialysis Access Grafts in Elderly Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This will be a prospective, single institution, parallel-group, single-blinded, randomized-controlled, two-arm, effectiveness study comparing autologous arteriovenous fistula versus hemodialysis access grafts in the elderly. The target sample size will include enrollment of 270 patients over a period of 5 years. The creation of an autologous arteriovenous fistula or placement of a hemodialysis access graft constitutes the two arms of the study.
Following the access creation the patients will be followed-up as per the standard and study protocol for a period of 2 years from the time of access creation.
The investigators will use block randomization to achieve a patient allocation ratio of 1:1, using varying blocks of sizes 4 and 6 in a random order as per a web-based/computer generated system maintained as a block randomization sequence/list concealed from the blinded clinical and trial research team until the end of trial. Patients will be randomly allocated based on this permuted sequence to either of the two intervention groups.
Masking will be performed and shall involve blinding of the patients participating in the trial. The research assistants involved with consenting, enrolling, data collection and follow-up, and the statistician analyzing the outcome measures will be blinded to the group assignment. The operating surgeon shall be blinded to the allocation process until the time of access creation following which the knowledge regarding the type of access creation by the surgeon is inevitable. All patients will be consented and their study related details including history, physical evaluations, diagnostic tests, etc., will be entered on a case report form and maintained on a web-based database. The patients will be followed-up for a period of 2 years from the time of initial access creation until the access is abandoned or rendered nonfunctional until the end of the study period.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Bright Benfor, MD
- Phone Number: 713-441-0147
- Email: bbenfor@houstonmethodist.org
Study Contact Backup
- Name: Bevin A Lopez, MS,CEP,CCRP
- Phone Number: 346-320-7421
- Email: balopez@houstonmethodist.org
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Recruiting
- Houston Methodist Hospital
-
Sub-Investigator:
- Carlos Bechara, MD
-
Sub-Investigator:
- Linda Le, MD
-
Sub-Investigator:
- Thomas Loh, MD
-
Principal Investigator:
- Eric Peden, MD
-
Contact:
- Bright Benfor, MD
- Phone Number: 713-441-0147
- Email: bbenfor@houstonmethodist.org
-
Contact:
- Bevin A Lopez, MS,CEP,CCRP
- Phone Number: 346-320-7421
- Email: balopez@houstonmethodist.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged ≥70 years of all ethnicities, and;
- Have vascular anatomy amenable to arteriovenous fistula creation, and;
- Diagnosed with End-stage Renal Disease stage 4 (GFR 15-29 ml/min 1.73m2) or stage 5 (GFR <15ml/min 1.73m2) as per the National Kidney Foundation guidelines needing vascular access for hemodialysis; or,
- Currently undergoing hemodialysis with a failure of previous access; or,
- Expected to undergo hemodialysis within 6 months of presentation.
Exclusion Criteria:
- Unable or refuse to abide with follow-up; or,
- Known hypercoagulability syndrome or a bleeding disorder; or,
- Intraoperative decision was made in favor of fistula instead of graft; or,
- Active infections; or,
- Evidence or suspicion of central vein stenosis but shall be included if a central vein catheter or pacemaker is implanted as long as the patient had a venogram within past 6 months.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Surgical fistula creation from patient's anatomy
Patients randomized to surgical arteriovenous fistula will have a fistula surgically created from their anatomy to be used for hemodialysis access.
|
Patient will be randomized via computer system, to receive the fistula or graft.
If fistula, surgeon creates fistula for hemodialysis access from patient's anatomy.
Other Names:
|
Active Comparator: Surgical graft implant
Patients randomized to surgical graft, will have a commercially available graft surgically implanted to be used for hemodialysis access.
|
Patient will be randomized via computer system, to receive the fistula or graft.
If fistula, surgeon creates fistula for hemodialysis access from patient's anatomy.
Other Names:
Patient will be randomized via computer system, to receive the fistula or graft.
If graft, surgeon implants hemodialysis access using an FDA approved graft.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Analyze hemodialysis (HD) access creation, arteriovenous (AV) fistula vs Graft, in elderly patients.
Time Frame: 12 months
|
Assess frequency of HD access use, abandonment, and patency at 12 months post-procedure.
We will communicate with the patient every month from date of surgery until 12 months to complete questionnaires to determine access use and patency for their study related access creation
|
12 months
|
Functional cumulative patency rate at 12 months
Time Frame: 12 months
|
Functional refers to the availability of the access for hemofiltration.
Primary patency refers to the successful use of a vascular access for hemodialysis without any surgical or endovascular intervention
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Using Disease Outcomes Quality Initiative quality of life tool to evaluate and compare the overall improvement in outcome with respect to morbidity in the 2 years post fistula/graft procedure
Time Frame: 2 years
|
Using Disease Outcomes Quality Initiative quality of life tool
|
2 years
|
To compare and analyze the estimated costs with both types of hemodialysis interventions and their postoperative outcomes.
Time Frame: 2 years
|
Analysis of hospital bills to compare the costs with both types of hemodialysis interventions
|
2 years
|
Using Disease Outcomes Quality Initiative quality of life tool to evaluate and compare the overall improvement in outcome with respect to mortality in the 2 years post fistula/graft procedure
Time Frame: 2 years
|
Using Disease Outcomes Quality Initiative quality of life tool
|
2 years
|
Using Disease Outcomes Quality Initiative quality of life tool to evaluate and compare the overall improvement in outcome with respect to patient's quality of life in the 2 years post fistula/graft procedure
Time Frame: 2 years
|
Using Disease Outcomes Quality Initiative quality of life tool
|
2 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Eric K Peden, MD, The Methodist Hospital Research Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00013220
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- CSR
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 Chronic Kidney Disease
-
3-C Institute for Social DevelopmentUniversity of North Carolina, Chapel HillCompletedChronic Kidney Diseases | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage4 | Pediatric Kidney Disease | Chronic Kidney Disease stage3 | Chronic Kidney Disease Stage V | Chronic Kidney Disease, Stage IV (Severe) | Chronic Kidney Disease Stage 2 | Chronic Kidney Disease, Stage IUnited States
-
Universiti Putra MalaysiaRecruitingChronic Kidney Diseases | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage4 | Chronic Kidney Disease stage3 | Chronic Kidney Disease Requiring Chronic DialysisMalaysia
-
National Taiwan University HospitalCompletedChronic Kidney Disease stage4 | Chronic Kidney Disease stage3 | Chronic Kidney Disease Stage 2 | Chronic Kidney Disease Stage 1Taiwan
-
Centre Hospitalier le MansLe Mans UniversiteWithdrawnFatigue | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage3 | Chronic Kidney Failure | Chronic Kidney Disease, Stage 4 (Severe)
-
Centre Hospitalier le MansLe Mans UniversiteRecruitingFatigue | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease stage4 | Chronic Kidney Disease Stage 3BFrance
-
American Academy of Family PhysiciansUniversity of Colorado, Denver; National Institute of Diabetes and Digestive... and other collaboratorsCompletedChronic Kidney Disease | Chronic Renal Insufficiency | Chronic Kidney Insufficiency | Chronic Renal Diseases | Kidney Insufficiency, ChronicUnited States
-
Lund UniversityBaxter Healthcare Corporation; Universidad de CórdobaCompletedEnd Stage Kidney Disease | Chronic Kidney Disease Requiring Chronic DialysisArgentina
-
Centre Hospitalier Saint Joseph Saint Luc de LyonNot yet recruitingKidney Failure, Chronic | Diet Habit | Chronic Kidney Disease stage3 | Chronic Kidney Disease Stage 3B | Chronic Kidney Disease, Stage 3 (Moderate) | Chronic Kidney Disease Stage 3A (Disorder)France
-
A.C. AbrahamsCompletedEnd Stage Renal Disease | Chronic Kidney Disease | End Stage Kidney Disease | Chronic Kidney FailureNetherlands
-
Far Eastern Memorial HospitalActive, not recruitingMetabolic Syndrome | Chronic Disease | Chronic Kidney Disease Stage 5 | Chronic Kidney Disease Stage 3 | Chronic Kidney Disease Stage 4 | Chronic Kidney Disease Stage 2 | Chronic Kidney Disease Stage 1Taiwan
Clinical Trials on Surgical fistula creation from patient's anatomy
-
Wake Forest University Health SciencesNational Institute on Aging (NIA)RecruitingHemodialysis Complication | End-Stage Kidney DiseaseUnited States