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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
117
Cliniques Universitaires Saint-Luc
Brussels, Belgium
Proportion of patients stopping 3 bags / day
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.
Time frame: During the treatment phase of 18 months
effect on clinical and biological determinants
• Metabolic control: HbA1c and lipid concentration (total, high-density lipoprotein \[HDL\], low-density lipoprotein \[LDL\], triglycerides, cholesterol)
Time frame: During 18 months, evaluated on month 3, 6, 9, 12 and 18.
effect on clinical and biological determinants
• Blood pressure control, evaluated by the number of anti-hypertensive agents and daily furosemide dose, and measured at the end of each study visit
Time frame: During 18 months, evaluated on month 3, 6, 9, 12 and 18.
effect on clinical and biological determinants
• Nutritional aspect: serum albumin and prealbumin concentrations based on the changes in percentage at various time points compared to baseline (V2)
Time frame: During 18 months, evaluated on month 3, 6, 9, 12 and 18.
effect on clinical and biological determinants
• Inflammatory profile: CRP concentrations
Time frame: During 18 months, evaluated on month 3, 6, 9, 12 and 18.
effect on clinical and biological determinants
• Left ventricular mass calculated following echocardiography
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Time frame: Month 9 and month 18.
effect on clinical and biological determinants
• Quality of life according to KDQoL
Time frame: Month 6, 12 and 18.
effect on clinical and biological determinants
• Residual renal function evaluated by calculated GFR
Time frame: During 18 months, evaluated on month 3, 6, 9, 12 and 18.
effect on clinical and biological determinants
• Peritoneal membrane permeability assessed by the PET
Time frame: On month 6, 12 and 18.
effect on clinical and biological determinants
• Number of hospitalisations and length (in days) of hospitalisation
Time frame: During the treatment phase of 18 months.
Safety endpoints
• Adverse events (AEs), treatment-emergent AEs and serious adverse events (SAEs)
Time frame: Durign the treatment phase of 18 months.
6.1.3 Safety endpoints
• Serum sodium concentration and icodextrin metabolites concentration
Time frame: On month 3, 6, 12 and 18.
safety endpoints
• Relevant clinical problems related to serum sodium concentration and to icodextrin metabolites accumulation
Time frame: During the treatment phase of 18 months.
Safety endpoints
• Incidence of skin rashes
Time frame: During the treatment phase of 18 months.
Safety endpoints
• Incidence of sterile peritonitis
Time frame: During the treatment phase of 18 months.