DiaSport - Endurance-orientated Training Program With Children and Adolescents on Maintenance Hemodialysis (DiaSport)
2017年11月6日 更新者：Prof. Dr. B. Hoppe、University Hospital, Bonn
DiaSport - Ausdauerorientiertes Trainingsprogramm Mit Kindern Und Jugendlichen an Der Dialyse (DiaSport - Endurance-orientated Training Program With Children and Adolescents on Maintenance Hemodialysis)
Physical activity is considered essential for optimal health, development, socialization and well-being of children.
However patients with end-stage renal disease (ESRD) are often restricted from participation in exercise activities.
This is especially true for children on hemodialysis (HD).
As a consequence their exercise capacity is reduced, both before, but most impressively after HD.
In a nationwide randomized, multi-center design this study aims to proof the influence of an individualised endurance training program by bicycle ergometer performed during dialysis on the efficacy of HD, measured as single pool Kt/V.
Secondary goals are to enhance physical performance, physical and mental well-being, and to improve measurable blood and treatment parameters (e.g.
haemoglobin level, amount of medication).
A positive impact of physical activity was observed in adults on HD, although most studies did not address this issue in a randomised protocol.
Despite this beneficial evidence in adults, sport is still not integrated as part of standard care in patients on maintenance HD.
The study protocol, developed in close collaboration with the German Sport University Cologne, differs substantially from previously published reports as it uses bicycle ergometer training in an upright position outside the dialysis couch and adapts the intensity of intervention to the patient's capabilities.
Based on the expected results the investigators will develop an individualised training program to be integrated in the standard care of (pediatric) patients on maintenance HD.
調査の概要
研究の種類
介入
入学 (実際)
66
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Bonn、ドイツ、53113
- University Hospital Bonn. Department of Pediatric and Adolescent Medicine, Division of Pediatric Nephrology
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
6年～19年 (子、大人)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- End stage renal disease with need of renal replacement therapy
- children and adolescents aged ≥6 to ≤19 years
- maintenance hemodialysis for at least 3 months
- Stable and appropriate dialysis condition in the last 4 weeks before inclusion to the study (basically stable blood and dialysate flow rate and same dialyser)
- single pool Kt/V according to Dialysestandard 2006 > 1.2
- Informed consent
Exclusion Criteria:
- Participation in another interventional clinical trial
- severe primary neurologic, orthopaedic or cardiac disease, or secondary disease known as a contraindication for endurance training
- uncontrolled hyper- or hypotension, or cardiac disease
- Recurrent uncontrolled epileptic seizures
- dialysis shunt at the lower limbs
- pregnancy
- already planned medical intervention, for example living donor kidney transplantation or any other surgery, within the first period of the trial which will cause cancelation of more then 3 training units in a row
- Subjects who are in dependency to the sponsor or the PI of the trial, or confined to an institution on judicial or official behalf
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：他の
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Bicycle-Ergometer Training Group
Performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes, with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions). In the second part of the study intervention will be prolonged for another 12 weeks. |
Performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions - first part of the study compared to no intervention). In the second part of the study both groups get the opportunity for another 12 weeks of individualised three times weekly bicycle-ergometer training during hemodialysis. |
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他の：Control
No intervention during hemodialysis during the first 12 weeks of the study. In the second part of the study a training program, according to that of the intervention group, will be performed with a performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes, with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions). |
Performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions - first part of the study compared to no intervention). In the second part of the study both groups get the opportunity for another 12 weeks of individualised three times weekly bicycle-ergometer training during hemodialysis. |
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change of single pool Kt/V (KDOQI Guidelines) - expressed as the change of single pool Kt/V from week 0 to 12 of intervention (period 1)
時間枠：12 weeks
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Change of single pool Kt/V (spKt/V) measured at week 12 (V1) compared to baseline (V0).
Single pool Kt/V is the standard measure to assess dialysis efficacy.
As dialysis efficacy is the primary aim of dialysis treatment and the spKt/V is the best way to measure efficacy this figure has an important clinical relevance for the patient.
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12 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change of the possible workload (maximum physical performance) achieved
時間枠：12 and 24 weeks
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The maximal possible workload will be determined by an exercise evaluation program with increasing power on a leg bicycle ergometer before a hemodialysis session, measuring the peak oxygen uptake (VO2-peak), heart rate, blood pressure and lactate levels during exercise.
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12 and 24 weeks
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Quality of Life
時間枠：12 and 24 weeks
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For quality of life assessment the validated and standardized PedsQL® questionnaires will be filled in by patients and parents.
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12 and 24 weeks
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Change of solute removal during hemodialysis
時間枠：12 and 24 weeks
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Solute removal during hemodialysis has a clear impact on the patient's health and well-being, as it reduces sequelae and offers the patient less restrictions on their diet, which would lead to a better compliance.
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12 and 24 weeks
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Change of solute removal in the two compartment model (assessed in a subgroup of patients)
時間枠：12 and 24 weeks
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Solute removal in the two compartment model will only be analyzed in patients 12 years of age or older with explicit consent to a second blood drawing 30 minutes after end of hemodialysis session.
It was previously used showing a significant enhancement during exercise, explained by an increase of skeletal muscles perfusion during exercise.
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12 and 24 weeks
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Inflammation, nutritional status and bone metabolism
時間枠：12 and 24 weeks
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The nutritional status and bone metabolism will be determined as they are important for optimal health and growth of paediatric hemodialysis patients.
Evidence is based on studies that showed trends towards a better nutritional status and less chronic inflammation.
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12 and 24 weeks
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Body Composition Monitoring (BCM)
時間枠：12 and 24 weeks
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Body Cpomposition Monitoring (BCM) will be performed to exermine further information on nutrional status, overhydration and muscle growth.
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12 and 24 weeks
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Change of number and dose of medication needed
時間枠：12 and 24 weeks
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Number and dose of medication will be recorded, changes will be evaluated, and data will be correlated to e.g. the measured blood pressure (antihypertensive drugs) or haemoglobin levels (EPO or EPO stimulating agents).
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12 and 24 weeks
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Telomere length and Telomerase activity
時間枠：12 and 24 weeks
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Telomere length and telomerase activity [units] will be used as markers for cell survival, which may be influenced by endurance training.
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12 and 24 weeks
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- スタディチェア：Bernd Hoppe, MD、University Hospital of Bonn
- スタディチェア：Bettina Schaar, PhD、German Sport University, Cologne
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Schaar B, Feldkotter M, Nonn JM, Hoppe B. Cardiorespiratory capacity in children and adolescents on maintenance haemodialysis. Nephrol Dial Transplant. 2011 Nov;26(11):3701-8. doi: 10.1093/ndt/gfr014. Epub 2011 Mar 4.
- Hoppe B, Schaar B. The impact of nutrition and physical activity on long-term survival after pediatric solid organ transplantation. Pediatr Transplant. 2012 Nov;16(7):675-7. doi: 10.1111/j.1399-3046.2012.01663.x. Epub 2012 Feb 21. No abstract available.
- Feldkotter M, Thys S, Adams A, Becker I, Buscher R, Pohl M, Schild R, Pape L, Schmitt CP, Taylan C, Wygoda S, Klaus G, Fehrenbach H, Montoya C, Konrad M, Billing H, Schaar B, Hoppe B. Endurance-oriented training program with children and adolescents on maintenance hemodialysis to enhance dialysis efficacy-DiaSport. Pediatr Nephrol. 2021 Dec;36(12):3923-3932. doi: 10.1007/s00467-021-05114-8. Epub 2021 Jun 12. Erratum In: Pediatr Nephrol. 2021 Sep 9;:
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2012年9月1日
一次修了 (実際)
2017年10月1日
研究の完了 (実際)
2017年10月1日
試験登録日
最初に提出
2012年3月20日
QC基準を満たした最初の提出物
2012年3月20日
最初の投稿 (見積もり)
2012年3月22日
学習記録の更新
投稿された最後の更新 (実際)
2017年11月7日
QC基準を満たした最後の更新が送信されました
2017年11月6日
最終確認日
2017年11月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。