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Efficacy and Safety of a Double Icodextrin Dose in Elderly Incident CAPD Patients on Incremental PD.

Phase 4
Completed
Conditions
Renal Insufficiency
Interventions
Registration Number
NCT01944852
Lead Sponsor
Pr Eric Goffin
Brief Summary

The DIDo study is an open-label, randomised, multicentre study with 2 parallel groups in incident CAPD patients aged of 65 at minimum :

* One group in which patients will receive 2 bags of icodextrin/day and 1 bag of glucose

* One group in which patients will receive 1 bag of icodextrin/day and 2 bags of glucose.

Detailed Description

The DiDo study evaluates efficacy and safety of a Double Icodextrin Dose in elderly incident CAPD patients on incremental Peritoneal Dialysis therapy.

The objective is to demonstrate the superiority and safety of using 2, as compared to 1, icodextrin bags / day, in a cohort of elderly incident continuous ambulatory peritoneal dialysis (CAPD) patients using incremental peritoneal dialysis (PD) (3 bags / day), with the aim of prolonging the period of time for which incremental PD can be used.

This is a phase IV open-label, randomised, multicentre study with 2 parallel groups, which will take place in up to 30 hospital out-patient clinics un Europe.

It is planned to include 160 patients on the run-in period in order to obtain 100 randomised patients and 90 patients evaluable at the primary endpoint (45 in each group). The duration of patient recruitment is estimated at 1 year but this may be extended until all 160 patients are recruited.

There are 2 periods: a run-in period of 2 months and a treatment period of 18 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
117
Inclusion Criteria

Run-in period

  • Incident CAPD patients who require incremental PD and in whom a 1.5L dialysate can be safely instilled,
  • Creatinine clearance < 20 ml / min (calculated with the modification of the Diet in renal Disease [MDRD] formula),
  • Age ≥ 60 years,
  • Patients willing and able to give written informed consent and comply with the requirements of the study protocol.

Treatment period

  • Patients having successfully completed the run-in period (achieving euvolemia)
Exclusion Criteria

Run-in period

  • Contraindication for CAPD according to local practice,
  • Life expectancy < 6 months,
  • Known allergy to icodextrin (cloudy dialysate or skin rash),
  • Need for amino-acid prescription,
  • Treatment with any investigational product within 30 days prior to signature of the informed consent form (ICF)
  • History of drug or alcohol abuse within 3 months prior to the signature of the ICF.

Treatment period

  • Severe symptomatic arterial hypotension at the end the run-in period in the Investigator's opinion,
  • Excessive ultrafiltration (UF) during the run-in period,
  • Allergy to icodextrin discovered during the run-in period,
  • Impossibility to achieve adequate PD regimen within the run-in period (catheter dysfunction, peritoneal leaks, inadequate compliance, psychosocial reasons)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1 icodextrin bag/dayIcodextrin1 icodextrin bag + 2 glucose bags per day
2 icodextrin bags/dayIcodextrin2 icodextrin bags + 1 glucose per day
Primary Outcome Measures
NameTimeMethod
Proportion of patients stopping 3 bags / dayDuring the treatment phase of 18 months

The primary endpoint will be the proportion of patients stopping 3 bags / day for the following reasons:

* Use of \> 15 % hypertonic glucose dialysate 3.86 % or \> 30 % hypertonic glucose dialysate 2.27 % over a 4-week period19-20,

* Transfer of the patient to another dialysis method (HD, APD, CAPD with \> 3 bags / day) for any reason,

* Death of the patient.

Secondary Outcome Measures
NameTimeMethod
6.1.3 Safety endpointsOn month 3, 6, 12 and 18.

• Serum sodium concentration and icodextrin metabolites concentration

safety endpointsDuring the treatment phase of 18 months.

• Relevant clinical problems related to serum sodium concentration and to icodextrin metabolites accumulation

effect on clinical and biological determinantsDuring the treatment phase of 18 months.

• Number of hospitalisations and length (in days) of hospitalisation

Safety endpointsDuring the treatment phase of 18 months.

• Incidence of sterile peritonitis

Trial Locations

Locations (1)

Cliniques Universitaires Saint-Luc

🇧🇪

Brussels, Belgium

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