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Peritoneal DialysisRAPPERNCT06060951

Relating Abdominal Complications With Peritoneal Pressure Estimation and Reporting

An observational study of Peritoneal Dialysis and Kidney Failure, Chronic, run by Imperial College Healthcare NHS Trust at 2 sites in United Kingdom.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a prospective observational study in people treated with peritoneal dialysis for kidney failure to investigate whether estimated intraperitoneal pressure (eIPP) is correlated with non-infectious PD-related complications in end-stage renal failure patients. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Estimated intraperitoneal pressure
How many people
300 participants
Where
2 sitesUnited Kingdom
Study dates
1 Oct 2023to 31 Jul 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: All patients with kidney failure treated with peritoneal dialysis are eligible.

Who may be able to join

  • Age 18 years or older
  • Diagnosis of end-stage renal failure requiring peritoneal dialysis as renal replacement therapy
  • Ability to give informed consent and comply with study procedures.

Who cannot join

  • Known allergy or hypersensitivity to any component of the dialysis solution.
  • Inability or unwillingness to comply with study procedures.

Trial locations and contacts

2 sites in 1 country.

Ka Chun Leung, MRCP(UK) contact

+447838907447

kachun.leung@nhs.net

United Kingdom2 sites
  • Birmingham Heartlands Hospital

    Birmingham, B9 5SS

    Jyoti Baharani, FRCP(UK), +441214242000, jyoti.baharani@uhb.nhs.uk

    Jyoti Baharani, FRCP(UK)

  • Hammersmith Hospital

    London, W12 0HS

    Richard Corbett, PhD, +442033136647 ext. 36647, richard.corbett@imperial.ac.uk

    Ka Chun Leung, MRCP(UK), +447838907447, kachun.leung@nhs.net

Other trials in United Kingdom

About this study

Official title: To Investigate the Relationship Between Estimated Intraperitoneal Pressure and Non-infectious Peritoneal Dialysis (PD)-Related Abdominal Complications

This is a prospective observational study in people treated with peritoneal dialysis for kidney failure to investigate whether estimated intraperitoneal pressure (eIPP) is correlated with non-infectious PD-related complications in end-stage renal failure patients. It looks to understand how both peritoneal dialysis complications (including fluid leaks and hernias) along with gastrointestinal symptoms are associated with eIPP in people treated with PD.

Read the detailed description

Peritoneal dialysis is an important treatment option for kidney failure. It involves the instillation of fluid into the peritoneal cavity. The choice of volume of fluid used has a limited evidence base but will be between 1 liter to 2.5 liters depending on clinical preference. The intraperitoneal pressure (IPP) that results from this fluid varies widely between patients. However, IPP is difficult to implement clinically. There is some evidence that higher IPP is associated with an increased rate of non-infectious PD complications. These complications are mainly leaks (escape of peritoneal fluid from the peritoneal cavity) and hernias.

New methods for estimating IPP (eIPP) have been recently developed but not validated clinically. This study looks to the association of eIPP and non-infectious PD complications as well as understanding whether there is an association between eIPP and patients' burden of symptoms.

This is an observational study, no changes to fill volume or treatment will result from the eIPP. Clinicians and nurses involved in the care of the patient will not receive feedback on the eIPP measurement. This simple study will look to recruiting patients with informed consent. Those who agree to enter the study will have a small number of non-invasive measurements made at the time of a routine clinic visit. A short survey will also be administered both at the initial visit, along with 3 and 12 months later. The research team, will review the patients' notes at 12 months following recruitment for evidence of non-infectious PD-related complications.

This research proposal has informed by interaction with people with lived experience. The scientific rationale has been tested by a discussion with experts in PD in other centres.

Given that this is an observational study, individuals will not be exposed to increased clinical risk through the alteration of PD fill volume or novel procedures. The greatest burden for participants will be the completion of three short, validated survey questionnaires over 12 months.

Confidentiality will be maintained with the use of pseudonymisation to maintain participants confidentiality.

Being tested
Estimated intraperitoneal pressure
Keywords
Intraperitoneal pressure, Gastrointestinal complications, pleuroperitoneal fistulas, patent processus vaginalis, hernia
Medical subject headings
Kidney Failure, Chronic, Hernia, Abdominal, Hernia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Estimated intraperitoneal pressureDiagnostic test

    The following anthropometric measurements are required:

    1. Height: measured standing with shoes off
    2. Weight: "dry weight" should be used
    3. The distance from the decubitus plane to the mid-axillary line was measured
    4. Waist circumference: measured with a tape measure wrapped above the iliac crests around the level of the umbilicus.

    The estimated IPP will be assessed using different equations.

Study groups in NCT06060951
Study groupRoleWhat they receive
Incident cohortIncluding all patients from the time of PD catheter insertion until 8 weeks after starting PD
Receives: Diagnostic Test: Estimated intraperitoneal pressure
Prevalent cohortIncluding all patients treated with PD who are greater than 8 weeks from the start of dialysis.
Receives: Diagnostic Test: Estimated intraperitoneal pressure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Non-infectious peritoneal dialysis (PD)-related complications

    Incidence of non-infectious peritoneal dialysis (PD)-related complications identified by the clinical team caring for the patient including the development of a new:

    • Hernia
    • Pleuroperitoneal fistula (PPF)
    • Patent processus vaginalis (PPV)
    • Retroperitoneal leak

    Measured: 3 and 12 months following study recruitment.

Secondary outcomes (2)
  1. Gastrointestinal complications

    Patient-reported outcome changes on the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire:

    GSRS is a 15-item interview-based scale, each rated on a 7-point Likert scale (1-7), higher scores indicating worse symptoms.

    GSRS items fall into five scales:

    1. Abdominal pain (includes abdominal pain, hunger pains, and nausea)
    2. Reflux syndrome (covers heartburn and acid regurgitation)
    3. Diarrhoea syndrome (encompasses diarrhoea, loose stools, and urgent need for defecation)
    4. Indigestion syndrome (includes borborygmus, abdominal distension, eructation, and increased flatus)
    5. Constipation syndrome (covers constipation, hard stools, and feeling of incomplete evacuation) Scores are calculated as the mean of completed items within each scale (min score: 1, max score: 7), higher scores indicating more severe symptoms.

    We also track the number of participants referred for surgical fixation of non-infectious PD-related complications.

    Measured: 3 and 12 months following study recruitment.

  2. Change of dialysis modality

    Number of Participants with modality change to automated peritoneal dialysis (APD) Number of Participants with transferring to haemodialysis due to non-infectious complications

    Measured: 3 and 12 months following study recruitment.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Sep 2023
  2. Study start1 Oct 2023 (estimated)
  3. Primary completion31 Dec 2024 (estimated)
  4. Study completion31 Jul 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06060951
Sponsor's protocol ID
23HH8380
Other IDs
326995
Acronym
RAPPER
Status last verified
Sep 2023
First submitted
21 Sep 2023
Last updated
29 Sep 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The Chief Investigator will preserve the confidentiality of participants taking part in the study and is registered under the Data Protection Act. Participants' information will be pseudonymized when possible. Only the pseudonymized form of data will be shared with researchers from other organizations, such as universities, National Health Service (NHS) organizations, or companies involved in health and care research in the UK or abroad, in compliance with ethical and legal requirements. Data collection, storage, and analysis will comply with data protection regulations, including the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018. All participants' information will be stored securely and analyzed using a local computer with strict arrangements for access and use, ensuring that the information is used only for health and care research or to contact participants about future research opportunities. No cloud service will be involved.

Publications

  • Bello AK, Okpechi IG, Osman MA, Cho Y, Cullis B, Htay H, Jha V, Makusidi MA, McCulloch M, Shah N, Wainstein M, Johnson DW. Epidemiology of peritoneal dialysis outcomes. Nat Rev Nephrol. 2022 Dec;18(12):779-793. doi: 10.1038/s41581-022-00623-7. Epub 2022 Sep 16.

    PubMed 36114414
  • Leblanc M, Ouimet D, Pichette V. Dialysate leaks in peritoneal dialysis. Semin Dial. 2001 Jan-Feb;14(1):50-4. doi: 10.1046/j.1525-139x.2001.00014.x.

    PubMed 11208040
  • Chan R, Walker RJ, Samaranayaka A, Schollum J. Long-term impact of early non-infectious complications at the initiation of peritoneal dialysis. Perit Dial Int. 2023 Jan;43(1):53-63. doi: 10.1177/08968608221132647. Epub 2022 Nov 3.

    PubMed 36325812
  • Outerelo MC, Gouveia R, Teixeira e Costa F, Ramos A. Intraperitoneal pressure has a prognostic impact on peritoneal dialysis patients. Perit Dial Int. 2014 Sep-Oct;34(6):652-4. doi: 10.3747/pdi.2012.00192. No abstract available.

    PubMed 25228214
  • Fischbach M, Terzic J, Becmeur F, Lahlou A, Desprez P, Battouche D, Geisert J. Relationship between intraperitoneal hydrostatic pressure and dialysate volume in children on PD. Adv Perit Dial. 1996;12:330-4.

    PubMed 8865930
  • Fischbach M, Desprez P, Donnars F, Geisert J. Hydrostatic intraperitoneal pressure in children on peritoneal dialysis: practical implications. An 18-month clinical experience. Adv Perit Dial. 1994;10:294-6.

    PubMed 7999848
  • Castellanos LB, Clemente EP, Cabanas CB, Parra DM, Contador MB, Morera JCO, Daly JA. Clinical Relevance of Intraperitoneal Pressure in Peritoneal Dialysis Patients. Perit Dial Int. 2017 Sep-Oct;37(5):562-567. doi: 10.3747/pdi.2016.00267. Epub 2017 Jul 11.

    PubMed 28698250
  • Scanziani R, Dozio B, Baragetti I, Maroni S. Intraperitoneal hydrostatic pressure and flow characteristics of peritoneal catheters in automated peritoneal dialysis. Nephrol Dial Transplant. 2003 Nov;18(11):2391-8. doi: 10.1093/ndt/gfg353.

    PubMed 14551372
  • de Jesus Ventura M, Amato D, Correa-Rotter R, Paniagua R. Relationship between fill volume, intraperitoneal pressure, body size, and subjective discomfort perception in CAPD patients. Mexican Nephrology Collaborative Study Group. Perit Dial Int. 2000 Mar-Apr;20(2):188-93.

    PubMed 10809242
  • Li X, Ma T, Hao J, Song D, Wang H, Liu T, Zhang Y, Abi N, Xu X, Zhang M, Sun W, Li X, Dong J. Novel equations for estimating intraperitoneal pressure among peritoneal dialysis patients. Clin Kidney J. 2023 Feb 2;16(9):1447-1456. doi: 10.1093/ckj/sfad021. eCollection 2023 Sep.

    PubMed 37664572
  • Dejardin A, Robert A, Goffin E. Intraperitoneal pressure in PD patients: relationship to intraperitoneal volume, body size and PD-related complications. Nephrol Dial Transplant. 2007 May;22(5):1437-44. doi: 10.1093/ndt/gfl745. Epub 2007 Feb 17.

    PubMed 17308323
  • Yi C, Wang X, Ye H, Lin J, Yang X. Patient-reported gastrointestinal symptoms in patients with peritoneal dialysis: the prevalence, influence factors and association with quality of life. BMC Nephrol. 2022 Mar 9;23(1):99. doi: 10.1186/s12882-022-02723-9.

    PubMed 35264119
  • Durand PY, Chanliau J, Gamberoni J, Hestin D, Kessler M. Routine measurement of hydrostatic intraperitoneal pressure. Adv Perit Dial. 1992;8:108-12.

    PubMed 1361762
  • Schmitt CP, Zaloszyc A, Schaefer B, Fischbach M. Peritoneal dialysis tailored to pediatric needs. Int J Nephrol. 2011;2011:940267. doi: 10.4061/2011/940267. Epub 2011 Jun 8.

    PubMed 21761001
  • Du BOIS D, Du BOIS EF. CLINICAL CALORIMETRY: TENTH PAPER A FORMULA TO ESTIMATE THE APPROXIMATE SURFACE AREA IF HEIGHT AND WEIGHT BE KNOWN. Archives of Internal Medicine. 1916;XVII(6_2): 863-871. https://doi.org/10.1001/archinte.1916.00080130010002

Questions about this trial

What is this clinical trial studying?

An observational study of Peritoneal Dialysis and Kidney Failure, Chronic, run by Imperial College Healthcare NHS Trust at 2 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 29 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Richard Corbett, PhD (+442033136647 ext. 36647, richard.corbett@imperial.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Non-infectious peritoneal dialysis (PD)-related complications (time frame: 3 and 12 months following study recruitment.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06060951, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Sep 2023.

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