Peritoneal dialysis using icodextrin-based solutions for patients with advanced heart failure and chronic kidney disease

ISRCTN ISRCTN22848383
DOI https://doi.org/10.1186/ISRCTN22848383
Secondary identifying numbers 14080
Submission date
08/01/2015
Registration date
09/01/2015
Last edited
15/01/2021
Recruitment status
Stopped
Overall study status
Stopped
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Heart failure is a condition caused by the heart failing to pump enough blood around the body at the right pressure. Once patients with severe heart failure are taking the maximum tolerated dose of heart failure medication there are no other treatments available for those who still have symptoms of shortness of breath, limited mobility and poor quality of life. In studies many patients say that they would prefer treatments that improve their quality of life even at the expense of reduced length. Peritoneal dialysis involves pumping dialysis fluid into the space inside the abdomen (tummy) to draw out waste products from the blood. The aim of this study is to find out if peritoneal dialysis can be an effective treatment for patients with heart failure causing severe symptoms and reduced kidney function.

Who can participate?
Patients with severe heart failure and chronic kidney disease, who are taking an optimal dose of heart failure medication and considered suitable for peritoneal dialysis

What does the study involve?
Participants are randomly allocated to receive either best standard heart failure care (control group) or best standard heart failure care with peritoneal dialysis (intervention group). Participants have five study visits over a 32-week period. Depending on the visit, participants complete a range of quality of life and symptom questionnaires, a 6-minute walk distance test, blood test, 24-hour urine test, estimation of body composition and weight measurement, as well as questions about medical history and drug dosage.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Royal Derby Hospital (UK)

When is the study starting and how long is it expected to run for?
March 2015 to September 2016

Who is funding the study?
British Heart Foundation (UK)

Who is the main contact?
Melissa Benavente
Melissa.Benavente@nottingham.ac.uk

Contact information

Ms Melissa Benavente
Scientific

5048, The Medical School
Royal Derby Hospital Centre
Derby
DE22 3DT
United Kingdom

Phone +44 (0)1332 724636
Email Melissa.Benavente@nottingham.ac.uk

Study information

Study designRandomised; Interventional
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titlePD-HF: a multicentre randomised controlled trial of Peritoneal Dialysis using icodextrin-based solutions for patients with advanced Heart Failure and stage 3-4 chronic kidney disease
Study acronymPD-HF
Study objectivesOnce patients with severe heart failure (HF) are taking the maximum tolerated dose of heart failure medication there are no other treatments available for those who still have symptoms of shortness of breath, limited mobility and poor quality of life. In studies many patients say that they would prefer treatments that improve quality of life even at the expense of reduced length. The purpose of this study is to find out if peritoneal dialysis can be an effective treatment for patients with heart failure causing severe symptoms and reduced kidney function.
Ethics approval(s)14/EM/1174
Health condition(s) or problem(s) studiedTopic: Cardiovascular disease; Subtopic: Cardiovascular (all Subtopics); Disease: Cardiovascular
InterventionParticipants will be randomised into receiving best standard heart failure care (control group) or best standard heart failure care with peritoneal dialysis (intervention group).
Intervention typeProcedure/Surgery
Primary outcome measure1. Assess the efficacy of ultrafiltration by PD
2. To assess the efficacy of ultrafiltration by PD in patients with severe HF and moderate CKD on symptoms of HF
Secondary outcome measuresN/A
Overall study start date30/03/2015
Completion date30/09/2016
Reason abandoned (if study stopped)Participant recruitment issue

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 130; UK Sample Size: 130
Total final enrolment10
Key inclusion criteria1. Aged>18, no upper age limit
2. Severe HF (New York Heart Association grade III or IV)
3. Chronic Kidney Disease stage 34, (MDRD estimated GFR of 1660ml/min on 2 occasions >3 months apart)
4. Fluid overload resistant to diuretics* OR hospital admission for heart failure in last 6 months
5. Left ventricular ejection fraction = 40% in the last 2 years
6. Using optimal HF medication for = 8 weeks including ACE-inhibitor
OR angiotensin receptor blocker AND aldosterone antagonist AND beta-blocker unless intolerant and without dose change for = 4 Weeks.
7. Appropriately screened for revascularization and/or cardiac resynchronization therapy if clinically indicated.

*Diuretic resistance is defined as clinical signs of fluid overload despite >120mg of furosemide/3mg bumetanide/day.
‘Fluid overload’ is clinically defined as at least 2 of the following:
1. Peripheral or sacral oedema
2. Jugular venous distension = 7cm
3. Radiographic pulmonary oedema or pleural effusion
4. Enlarged liver or ascites
5. Pulmonary rales, paroxysmal nocturnal dyspnoea, or orthopnoea
Key exclusion criteria1. Does not wish to participate
2. Mental incapacity to consent
3. CKD stage 5 (estimated GFR of < 15ml/min)
4. Normal renal excretory function (estimated GFR of >60ml.min)
5. Haemodynamically significant valvular disease amenable to surgery
6. Cardiac or renal transplantation
7. Considered by the investigator to be unsuitable for PD due to previous abdominal surgeries, peritonitis, social circumstances or other reason
Date of first enrolment30/03/2015
Date of final enrolment30/09/2016

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Royal Derby Hospital
Uttoxeter Road
Derby
DE22 3NE
United Kingdom

Sponsor information

University of Nottingham (UK)
University/education

c/o Ms. Angela Shone
Head of Research Governance
Research & Graduate Services
King’s Meadow Campus
Lenton Lane
Nottingham
NG7 2NR
England
United Kingdom

ROR logo "ROR" https://ror.org/01ee9ar58

Funders

Funder type

Charity

British Heart Foundation
Private sector organisation / Trusts, charities, foundations (both public and private)
Alternative name(s)
the_bhf, The British Heart Foundation, BHF
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planNot provided at time of registration
IPD sharing planThis trial was halted due to extreme difficulty with recruitment. Only 10 participants were enrolled. Due to the paucity of data the researchers do not have any plans to make the data publicly available.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/09/2019 14/01/2021 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

15/01/2021: The trial was stopped due to participant recruitment issues. Total final enrolment and IPD sharing statement added.
14/01/2021: Publication reference added.
12/01/2021: Contact details updated.
18/12/2020: Internal review.
16/06/2016: Plain English summary added.