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Carry Life UF系统在持续性非卧床腹膜透析患者中的疗效与安全性临床研究:一项前瞻性、多中心、随机、交叉研究方案

A clinical study of efficacy and safety of the Carry Life UF system in continuous ambulatory peritoneal dialysis patients: protocol for a prospective, multicenter, randomized, crossover study.

作者信息

Wilkie Martin, de Leon Charlotte, Carlsson Ola, Hegbrant Jörgen, Heimbürger Olof

机构信息

Sheffield Kidney Institute, Sheffield Teaching Hospitals, Sheffield, UK.

Triomed AB, Lund, Sweden.

出版信息

BMC Nephrol. 2025 Apr 3;26(1):174. doi: 10.1186/s12882-025-04095-2.

Abstract

BACKGROUND

Carry Life UF is a novel peritoneal dialysis (PD) technology for improved fluid management using steady concentration PD (SCPD). The Carry Life UF treatment starts with a manual peritoneal fill of 1.36% glucose PD fluid, followed by a 5-hour treatment where small amounts of glucose are continuously added to maintain a stable intraperitoneal glucose concentration. A recent in-center clinical study using the Carry Life UF system demonstrated higher ultrafiltration (UF) rates, more efficient use of glucose (increased UF volume/gram of glucose absorbed), and greater sodium removal with the Carry Life UF treatments compared with a 2.27% glucose continuous ambulatory PD (CAPD) dwell. The aim of this study is to compare efficacy and safety of the Carry Life UF system with a standard CAPD prescription in the home setting.

METHODS

A prospective, multicenter, randomized, crossover study of 19 adult subjects at up to 12 sites in Italy, Sweden and the UK will complete the investigation. End-stage kidney disease patients with a CAPD prescription of 2-4 exchanges per day, including at least one 2.27% glucose dwell, will be included. After a Carry Life UF glucose dose determination phase performed in-clinic, subjects will be randomized to start the home treatment part of the study with either the control arm (2.27% glucose CAPD dwell) or the Carry Life UF arm (11 or 15 g/h glucose dose), each for four weeks. The primary endpoint is UF volume comparing the control CAPD 2.27% glucose dwell with the Carry Life UF treatment. Secondary endpoints include adverse event rates, peritoneal sodium removal, glucose UF efficiency, and peak dialysate glucose concentration.

DISCUSSION

This study will evaluate a novel PD technology in the home environment. Challenging aspects include the need to accurately measure UF volumes at home and to support subjects in using a novel technology. The study design considers important parameters for precise UF volume measurements and provides detailed weighing instructions to the study team to ensure consistency between study centers. Research nursing support will be provided for training of subjects and to support endpoint data collection in the subjects' home. Due to the significant burden associated with the study, subjects will be offered a fair compensation, in accordance with local regulations.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05874804 Registration date: 18th of April 2023.

摘要

背景

Carry Life UF是一种新型腹膜透析(PD)技术,采用稳定浓度腹膜透析(SCPD)改善液体管理。Carry Life UF治疗开始时手动向腹腔内注入1.36%葡萄糖腹膜透析液,随后进行5小时治疗,期间持续添加少量葡萄糖以维持腹腔内葡萄糖浓度稳定。最近一项使用Carry Life UF系统的中心临床研究表明,与2.27%葡萄糖持续非卧床腹膜透析(CAPD)驻留相比,Carry Life UF治疗的超滤(UF)率更高,葡萄糖利用更高效(超滤量/吸收的葡萄糖克数增加),钠清除更多。本研究的目的是在家庭环境中比较Carry Life UF系统与标准CAPD处方的疗效和安全性。

方法

一项针对意大利、瑞典和英国多达12个地点的19名成年受试者的前瞻性、多中心、随机、交叉研究将完成此项调查。将纳入每天进行2 - 4次交换(包括至少一次2.27%葡萄糖驻留)的终末期肾病患者。在临床进行Carry Life UF葡萄糖剂量测定阶段后,受试者将被随机分组,开始研究的家庭治疗部分,对照组采用(2.27%葡萄糖CAPD驻留)或Carry Life UF组(11或15克/小时葡萄糖剂量),每组为期四周。主要终点是比较对照CAPD 2.27%葡萄糖驻留与Carry Life UF治疗的超滤量。次要终点包括不良事件发生率、腹膜钠清除、葡萄糖超滤效率和透析液葡萄糖峰值浓度。

讨论

本研究将在家庭环境中评估一种新型腹膜透析技术。具有挑战性的方面包括需要在家中准确测量超滤量以及支持受试者使用新技术。研究设计考虑了精确超滤量测量的重要参数,并向研究团队提供了详细的称重说明,以确保各研究中心之间的一致性。将提供研究护理支持,用于培训受试者并支持在受试者家中收集终点数据。由于该研究负担较大,将根据当地法规给予受试者合理补偿。

试验注册

ClinicalTrials.gov标识符:NCT05874804 注册日期:2023年4月18日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ccd/11969901/e1d70f705877/12882_2025_4095_Fig1_HTML.jpg

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