MedPath

Peritoneal Dialysis in Congestive Heart Failure

Phase 3
Terminated
Conditions
Congestive Heart Failure
Interventions
Registration Number
NCT01124227
Lead Sponsor
Martini Hospital Groningen
Brief Summary

Rationale: End-stage congestive heart failure is a serious invalidating condition with a poor prognosis and increasing incidence. Non-randomized observations showed peritoneal dialysis (PD) in these patients to improve clinically from NYHA stadium III-IV to as low as NYHA stadium I-II. A randomized trial is needed to test whether PD improves symptoms in this condition and to find an optimal scheme.

Objective: To improve symptomatology in severe chronic failure patients. Study design: Open, parallel intervention trial comparing 2 schemes of peritoneal dialysis with icodextrin (Extraneal®) with standard medical therapy..

Study population: Patients with chronic refractory left ventricular congestive heart failure (LVEF \< 30%, older than 18 years).

Intervention: Peritoneal dialysis with one (night) or two (night and day) dwells with icodextrin (Extraneal®).

Main study parameters/endpoints: Reduction in NYHA classification of symptomatic Congestive Heart Failure at 8 months after start of PD therapy. Burden of congestive heart failure: measured by reduction in unfavorable days (noted by patients in diaries and including days of hospitalization for CHF-deterioration and death).

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
26
Inclusion Criteria
  • Age > 18 years
  • Refractory Left Ventricular Congestive Heart Failure: LVEF < 30%
  • Diminished renal function: eGFR < 60 ml/min
  • Clinically volume overloaded (Dyspnoea (NYHA III-IV), edema, and/or ascites)
  • Hospitalization for CHF during the last 6 months
  • Patient is on optimal cardiologic medical therapy, which has been stable for more than 4 weeks
  • Suitable for PD
Exclusion Criteria
  • Hypotension (SBP < 100 mmHg / MAP < 70) mmHg
  • Instable AP or recent (< 6 months) myocardial infarction.
  • Contraindications for PD (e.g. visual handicap, social)
  • Liver failure
  • COPD Gold class IV
  • Malignancy with life expectancy < 2 years
  • Non compliance
  • No informed consent
  • Poor mental health

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard Careicodextrin-
2 Icodextrin PD changes / dayicodextrin-
1 Icodextrin PD change/dayicodextrin-
Primary Outcome Measures
NameTimeMethod
Number of patients in NYHA class I, II, III, or IV as measure of quality of life8 months
Secondary Outcome Measures
NameTimeMethod
Quality of life measures8 months

Reduction in unfavorable days. Short-Form 36. Minnesota Living with Heart failure Questionnaire. 6 minute walk test. (re)hospitalization. Survival. Medication optimalisation. Cardial: LVH. Renal: GFR/ERPF/FF; KIM-1, NGAL, NAG. Volume status: ECV (radioactive and bio-impedance). Neurohumoral and inflammatory parameters.

Trial Locations

Locations (1)

Martini Hospital

🇳🇱

Groningen, Netherlands

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