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Assessment of Bioimpedance and Vitamin D and LV Mass in PD Patients (FLUID Study)

Phase 2
Completed
Conditions
Disorders Associated With Peritoneal Dialysis
Interventions
Drug: Bioimpedance and Vitamin D
Drug: Usual care and Vitamin D
Device: Bioimpedance and Placebo
Drug: Usual care and placebo
Registration Number
NCT01045980
Lead Sponsor
St. Joseph's Healthcare Hamilton
Brief Summary

The main purpose of this study is to compare the effects of using bio-impedance analysis to guide management of fluid status versus routine clinical care on heart structure. In addition, Vitamin D is being assessed to determine its effect on heart structure.

Detailed Description

Patients on peritoneal dialysis are frequently hypervolemic which is associated with deleterious changes in left ventricular (LV) architecture including increased LV mass. In dialysis patients, increased LV mass is associated with death. Recent randomized trials have demonstrated that increasing small solute clearance is not associated with improved outcomes - hence an increased interest in the management of volume control in ESRD patients. Bioimpedance analysis is inexpensive, safe and easy to use and appears to be more useful than other techniques to assess volume status in dialysis patients. In addition, dialysis patients are vitamin D deficient and this is also associated with an increased LV mass and its inherent complications.

This study will evaluate the use of bioimpedance analysis versus usual care to assess and manage volume status and the use of vitamin D versus placebo in peritoneal dialysis patients and its effect on LV mass as measured by cardiac MRI.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
74
Inclusion Criteria
  • Age ≥18 years
  • on peritoneal dialysis
Exclusion Criteria
  • Contraindication to MRI including presence of a pacemaker, defibrillator, ferromagnetic cerebral aneurysm clips, cochlear implants or eye prosthesis, neurostimulators, shrapnel in vital locations, surgery within 6 weeks, severe claustrophobia and severe obesity
  • Previous amputation
  • Life or technique expectancy < 1 year
  • Pregnancy
  • Peritonitis in previous 3 months
  • Currently using more than one extraneal bag per 24-hours
  • Known icodextrin allergy
  • Currently using non-Baxter PD solutions
  • Inability to provide consent
  • Allergy to cholecalciferol
  • Serum Calcium > 2.55 mmol/L

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Bioimpedance and Vitamin DBioimpedance and Vitamin DBioimpedance and Vitamin D
Usual care and Vitamin DUsual care and Vitamin DUsual Care and Vitamin D3
Bioimpedance and PlaceboBioimpedance and PlaceboBioimpedance and Placebo
Usual Care and PlaceboUsual care and placeboUsual Care and Placebo
Primary Outcome Measures
NameTimeMethod
Left ventricular mass measured by cardiac MRI1 year
Secondary Outcome Measures
NameTimeMethod
Combined outcome of death, non-fatal CV event (stroke, MI, amputation, CHF), and transfer to HD for inadequacy or ultrafiltration failure3 years
Volume measures: bio-impedance (RXc graph, vector length, impedance ratio, phase angle, ECW:TBW ratio), weight, N-BNP, mean and pulse arterial pressure, number of anti-hypertensive agents3 years
Health-related quality of life (HRQOL)1 year
Physical function as measured by 6 minute walk test1 year
Serum and peritoneal inflammatory and fibrotic markers: albumin, CRP, IL-6, TNF-a1 year
Peritoneal membrane transport properties,measured by PET3 years
Renal and peritoneal solute clearance, 24-hour urine output and ultrafiltration volume3 years
left ventricular end-diastolic and systolic volumes, stroke volume and ejection fraction measure by MRI1 year
Fraility Score1 year

Trial Locations

Locations (2)

St. Joseph's Healthcare Hamilton

🇨🇦

Hamilton, Ontario, Canada

Population Health Research Institute - McMaster University

🇨🇦

Hamilton, Ontario, Canada

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