A research group formed by the North American chapter of the International Society for Peritoneal Dialysis has landed funding for its first project.
The North American Research Consortium in Peritoneal Dialysis (NARC-PD) had been planned for some years, says Peter Blake, MD, NAC’s president, but came together during a meeting held in June 2013 at Vanderbilt University in Nashville. Blake said the consortium recently received funding from Baxter Healthcare for its first research focus: a multicenter study looking at outcomes with peritoneal catheters and a review of best practices for catheter placement and early management strategies.
“This project was selected because of the critical importance of good catheter function for successful peritoneal dialysis,” said Blake. “PD is in a growth phase in North America at present, being driven by the recent introduction in the U.S. of bundled dialysis payments which emphasize the cost advantages of PD. Similarly, in Canada, provincial government renal agencies have also been encouraging PD expansion. For all this to be sustained and successful, programs need to have good PD catheter outcomes with low rates of non-function and infection.
“The hope is that this study will establish the true rates of these complications across multiple centers and will examine which placement-related practices are associated with best catheter outcomes,” said Blake. “Centers will then be able to benchmark their catheter outcomes against those of other centers and against nationwide results, in all cases using consistent study-wide definitions, and will be able to use the data to identify where exactly they are having problems and how they can resolve them.” The study group will look at differences in outcomes for catheter insertion, as done surgically, radiologically, and nephrologically, as well as review laparoscopic versus traditional placement techniques. The role of catheter flushing, catheter configuration, location of insertion site relative to the pelvis, length of break-in period, and a variety of other topics that are not well understood at present will be reviewed, said Blake.
The NAC Research Committee received expressions of interest to participate in the study from more than 40 centers in the U.S. and Canada. They considered a number of proposals to design and lead the proposed study and eventually combined two of these––one led by Robert Quinn, MD, from Alberta Health Services/University of Calgary and Matthew Oliver, MD, from Sunnybrook Health Sciences Centre, Toronto, and a second from Vanderbilt University led by Tom Golper, MD. The Vanderbilt group includes Rachel Fissell, MD and Adriana Hung, MD as well as Eric Wallace, MD, who is based at the University of Birmingham, Ala.
The Dialysis Outcome Practice Patterns Study Group will provide additional collaboration on the study because of their experience with multicenter dialysis studies. Francesca Tentori, MD also based at Vanderbilt, represents DOPPS involvement with the NARC study. “The whole leadership group is a wonderful combination of research experience and youthful enthusiasm. It combines methodologic excellence with core knowledge of PD,” said Blake. “Oliver and Quinn bring their experience with the Dialysis Measurement, Analysis and Reporting (DMAR) system from Canada. Tentori, Fissell, and Hung bring their experience from DOPPS. Wallace brings PD knowledge and enthusiasm and, of course, Golper brings leadership, experience and wisdom.”
For further updates on the research project, visit http://ispd.org/NAC/