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Days-Off Versus Daily Initial Peritoneal Dialysis Prescription

2026年11月2日 更新者：Bruce M Robinson、University of Michigan

Comparative Effectiveness of Days-Off Versus Daily Initial Peritoneal Dialysis Prescription

The purpose of this study is to compare days-off (5 or 6 days a week) with daily (7 days a week) peritoneal dialysis (PD) in adults who are starting PD to treat kidney failure and make at least 16 ounces (two cups) of urine a day. Once enrolled, participants will be placed into one of two groups by chance, like flipping a coin: days-off PD or daily PD. Participants will be asked to stay on the assigned PD schedule (days-off or daily) for at least 6 months. After that, participants will continue this schedule for as long as it continues to be right for their health. Participants will be followed for as long as they remain on PD, up to 24 months. Most participants assigned to the days-off schedule will switch to daily PD at some point between 6 and 24 months because of further drop in urine output. Other than days per week, all parts of participant's PD prescription will be decided by their care team at their regular monthly PD clinic visits, just as if they were not in the study. Study visits will happen around the time of these regular clinic visits. No extra trips are required. Participants will be asked to complete surveys. Most other study data will be collected from the medical chart. No blood or biological samples will be taken for the study.

調査の概要

状態

まだ募集していません

条件

介入・治療

研究の種類

介入

入学 (推定)

450

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。

研究連絡先

研究場所

  • アメリカ
    • California
      • Torrance、California、アメリカ、90502
        • Lundquist Institute at Harbor-UCLA Medical Center
        • 主任研究者：
          • Jenny Shen, MD
    • Georgia
      • Atlanta、Georgia、アメリカ、30322
        • Emory University
        • 主任研究者：
          • Jason Cobb, MD
    • Illinois
      • Evanston、Illinois、アメリカ、60208
        • Northwestern University
    • Indiana
      • Bloomington、Indiana、アメリカ、47405
        • University of Indiana
        • 主任研究者：
          • Nupur Gupta, MD
    • Michigan
      • Ann Arbor、Michigan、アメリカ、48109
        • University of Michigan
        • 主任研究者：
          • Balazs Szamosfalvi, MD
    • New York
      • New York、New York、アメリカ、10021
        • Rogosin Institute, Inc (New York-Presbyterian Hospital/Weill Cornell Medicine)
        • 主任研究者：
          • Daniil Shimonov, MD
      • New York、New York、アメリカ、10029
        • Mount Sinai School of Medicine (MSSM)
        • 主任研究者：
          • Sharma Shuchita, MD
    • North Carolina
      • Winston-Salem、North Carolina、アメリカ、27109
        • Wake Forest University School of Medicine (WFUSM)
        • 主任研究者：
          • Mariana Murea, MD
    • Texas
      • Dallas、Texas、アメリカ、75390
        • University of Texas Southwestern (UTSW)
    • Washington
      • Seattle、Washington、アメリカ、98195
        • University of Washington (UW)
        • 主任研究者：
          • Rajnish Mehrotra, MD, MS

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

18年歳以上 (大人、高齢者)

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:

  1. Willingness to give written informed consent prior to any study-related procedures being performed.
  2. End-stage kidney disease, with first maintenance dialysis (PD or HD) initiated within 120 days prior to randomization.
  3. Home PD initiated within 30 days prior to randomization, defined as first PD exchange performed at home following completion of PD training.
  4. Residual kidney function, measured on a clinically obtained 24-hour urine collection within 45 days prior to randomization, demonstrating both (a) urine volume ≥500mL/24 hours and (b) urine clearance (mean of urea and creatinine clearance) ≥6 to <12 L/min/1.73m2
  5. In the judgment of the treating nephrologist, expected to remain on PD for at least 6 months following randomization
  6. Expected to receive ongoing PD care at the study enrollment site for the duration of study follow-up.
  7. Willingness to accept either randomized treatment assignment, adhere to the treatment schedule, and adhere to protocol schedule of activities.
  8. Sufficient fluency in English or Spanish to understand study materials and complete study assessments.

Exclusion Criteria:

  1. A laboratory-documented decline of ≥50% in residual kidney function (24-hour urine volume or mean of urea and creatinine clearance) since initiation of maintenance dialysis (HD or PD).
  2. Initiated maintenance dialysis due to kidney transplant failure.
  3. During the run-in period, requirement of either of the following for clinical purposes: (a) 7-day-per-week PD prescription or (b) a daytime dwell, if receiving automated peritoneal dialysis (APD).
  4. Any other condition that, in the judgment of the investigator, would make the participant unsuitable for days-off PD for at least 6 months following randomization.
  5. Concurrent participation in another interventional clinical trial.
  6. Known pregnancy or nursing at the time of screening, or of child-bearing potential and planning for possible pregnancy during the study period.
  7. Any condition that, in the judgment of the investigator, would make the participant unsuitable for the study or preclude participation for at least 6 months following randomization (e.g., anticipated kidney transplantation, anticipated transfer of dialysis care outside a participating study site, life expectancy <6 months, or other significant medical, psychiatric, or social circumstances).

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：処理
  • 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
アクティブコンパレータ：Daily Peritoneal Dialysis (7 days/week)

Approximately 225 participants
手順：Daily Peritoneal Dialysis

After a 7-15 day run-in period of daily PD, participants remain on a daily PD prescription for the duration of follow-up. Other elements of the PD prescription are at the discretion of the clinical team.

Participants will be followed until death, long-term transfer to HD, kidney transplantation, recovery of kidney function such that maintenance dialysis is no longer required, participant withdrawal, or completion of 24 months of follow-up, whichever occurs first.
実験的：Days-off Peritoneal Dialysis (5-6 days/week)

Approximately 225 participants
手順：Days-off Peritoneal Dialysis

After a 7-15 day run-in period of daily PD, participants switch to PD prescription 5 or 6 days per week. Other elements of the PD prescription are at the discretion of the clinical team. The treatment assignment is continued for at least 6 months and then for as long as possible until clinically indicated otherwise. Many participants are expected to eventually switch to daily PD, intended as a long-term switch, to compensate for decline in residual kidney function over time.

Duration of follow-up is as in the active comparator arm.

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
Total number of composite clinical events during follow up
時間枠：Day 1 (start of randomized treatment) through Month 24 of follow-up

Each occurrence of the following during follow-up: (1) death, all cause; (2) long-term transfer to hemodialysis (HD), defined as transfer identified as long-term or identified as short-term but lasting ≥ 90 days; (3) peritoneal dialysis (PD)-related infection, defined as PD-associated peritonitis meeting International Society for Peritoneal Dialysis (ISPD) diagnostic criteria; and (4) hospitalization lasting ≥ 24 hours.
Day 1 (start of randomized treatment) through Month 24 of follow-up

二次結果の測定

結果測定
メジャーの説明
時間枠
Standardized Outcomes in Nephrology - Life Participation (SONG-LP) score (Patient reported outcome)
時間枠：Months 0, 1, 3, 9, 12, 18, and 24; Key secondary outcome is Month 0 to Month 6.

The SONG-LP instrument is a 4-item patient-reported outcome measure developed by the SONG initiative to assess life participation, i.e. the ability to take part in meaningful activities. The four items cover leisure activities, family activities, work (including employment, housework, and study), and social activities. Participants rate how often they were able to take part in each activity over the past month on a 5-point scale from 0 ("never") to 4 ("always"). The summary score is the mean of the four item scores and ranges from 0 to 4. Higher scores indicate greater life participation (better outcome).
Months 0, 1, 3, 9, 12, 18, and 24; Key secondary outcome is Month 0 to Month 6.
Illness Intrusiveness Ratings Scale (IIRS) score (Patient reported outcome)
時間枠：Months 0, 1, 3, 6, 9, 12, 18, and 24

The IIRS is a 13-item self-report instrument. It measures how much a person's illness and its treatment interfere with 13 life domains that are important to quality of life. The domains are health, diet, work, active recreation, passive recreation, financial situation, relationship with spouse or partner, sex life, family relations, other social relations, self-expression and self-improvement, religious expression, and community and civic involvement. Each item is rated on a 7-point scale from 1 ("not very much") to 7 ("very much"). The total score is the sum of the 13 item ratings and ranges from 13 to 91. Higher scores indicate greater illness intrusiveness (worse outcome).
Months 0, 1, 3, 6, 9, 12, 18, and 24
Kidney Disease Quality of Life 36-Item Short Form Summary Score (KDQOL-36 KSS) (Patient reported outcome)
時間枠：Months 0, 3, 6, 12, and 24

The KDQOL-36 is a 36-item, kidney disease-specific health-related quality of life instrument. Higher scores indicate better health related quality of life instrument. Items 1-12 make up the SF-12 generic core. The remaining 24 items form three kidney disease-specific subscales. Higher scores on the KDQOL-36 KSS indicate better health related quality of life.
Months 0, 3, 6, 12, and 24
Change in Kidney Disease Quality of Life 36-Item Short Form Survey (KDQOL-36) kidney disease-specific subscale scores (Patient reported outcome)
時間枠：Months 0, 3, 6, 12, and 24

Subscales include Burden of Kidney Disease (items 13-16), Symptoms and Problems of Kidney Disease (items 17-28), and Effects of Kidney Disease on Daily Life (items 29-36). Each kidney disease-specific subscale is scored from 0 to 100 according to the RAND scoring manual. Higher scores indicate better subscale-specific quality of life.
Months 0, 3, 6, 12, and 24
Number of episodes of low small-solute clearance (weekly Kt/V [peritoneal + renal] < 1.7).
時間枠：Day 1 through Month 24 of follow-up

Counts, for episodes of weekly urea clearance (peritoneal + renal) normalized to total body water (Kt/V [P+R]) < 1.7.
Day 1 through Month 24 of follow-up
Number of episodes of serum potassium ≥ 6.0 mEq/L
時間枠：Day 1 through Month 24 of follow-up

Counts, for episodes of hyperkalemia, defined as serum potassium ≥6.0 mEq/L
Day 1 through Month 24 of follow-up
Number of episodes of serum phosphate ≥ 7.0 mg/dL
時間枠：Day 1 through Month 24 of follow-up

Counts, for episodes of hyperphosphatemia, defined as serum phosphate ≥7.0 mg/dL
Day 1 through Month 24 of follow-up
Number of episodes of serum CO2 ≤17 mmol/L
時間枠：Day 1 through Month 24 of follow-up

Counts, for episodes of serum total carbon dioxide (CO2; bicarbonate) ≤ 17 mmol/L
Day 1 through Month 24 of follow-up
Number of episodes of serum sodium < 130 mEq/L
時間枠：Day 1 through Month 24 of follow-up

Counts, for episodes of hyponatremia, defined as serum sodium < 130 mEq/L.
Day 1 through Month 24 of follow-up

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。

スポンサー

University of Michigan

協力者

Patient-Centered Outcomes Research Institute

捜査官

  • 主任研究者：Bruce Robinson, MD, MS、University of Michigan

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 (推定)

2027年2月1日

一次修了 (推定)

2030年11月1日

研究の完了 (推定)

2030年11月1日

試験登録日

最初に提出

2026年11月2日

QC基準を満たした最初の提出物

2026年11月2日

最初の投稿 (実際)

2026年11月6日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月6日

QC基準を満たした最後の更新が送信されました

2026年11月2日

最終確認日

2026年11月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • HUM00302656
  • BPS-2025C1-44706 (その他の助成金/資金番号：Patient-Centered Outcomes Research Institute)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

De-identified study data will be deposited in the Patient-Centered Outcomes Data Repository (PCODR) at ICPSR.

IPD 共有時間枠

From date of final research report submission to PCORI for at least 7 years.

IPD 共有アクセス基準

Third party requests contact PCORI

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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