Peritoneal Dialysis Clinical Study Group
Peritoneal dialysis (PD) is one of the main treatments for advanced chronic kidney disease. It allows people to remain at home, preserving their independence and minimising the impact of dialysis on their lifestyle.
Around 1,300 people start on this form of dialysis every year in the UK. Despite significant improvements over the years, common problems remain, including technical issues leading to people having to switch to haemodialysis, and a death rate that, like haemodialysis, remains unacceptably high. There is a pressing need for research to address these issues.
Who we are
Our group is led by Dr Mark Lambie who is Senior Lecturer in Renal Medicine at Keele University and Consultant Nephrologist at the University Hospital of North Midlands, with strong support from Professors Martin Wilkie, Simon Davies and Edwina Brown.
Our membership is open to anyone with an interest and comprises of clinical researchers, nurses, doctors, patients, scientists and clinical research co-ordinators from across the UK.
Our aims:
- Building research capacity with a dynamic culture within peritoneal dialysis (PD).
- Delivering large-scale interventional studies that will change practice.
- Aligning future research to better involve patients and reflect their
priorities. - Improving patient experience and outcomes whilst on PD.
Impact:
We have strengthened and grown research in this area in the UK and our annual meetings have showcased clinical research activity and provided a forum for debate. Smaller, informal meetings have taken place at conferences and the PD academy meetings have stimulated ideas, the development of protocols and research grants.
Several competitive research grants (eg NIHR, BHF) have been awarded to PD research over the last few years with themes including:
- Older people (BOLDE, FEPOD)
- Decision making (YoDDA)
- Peritoneal membrane changes (PD CRAFT)
- Volume management (BIA study)
- Heart Failure, catheter function (UK Catheter study and PDOPPS)
- Exit site management (STOP)
Patient partners have been involved in study design and grant preparation as well as given presentations at the meetings.
Experimental research is contributed to from the Wales Kidney Research Unit as part of the EuTri PD initiative, developing research scientists from across Europe.
Evidence gaps and challenges
PD studies remain limited by the need for specialist nursing support to the research nurses for data collection.
Given limited number of PD patients in any country, and difficulties in securing large grants to fund meaningful clinical trials, there are preliminary discussions about forming an international trials network.
IMPROVE-PD should significantly increase research capacity within European PD research, with 3 funded PhDs coming to UK units, funded by Horizon 2020.
Future plans
- Strengthening existing, and developing new, national and international collaborations.
- Optimising the use of existing resources such as national and international registries, the UK Biobank and the Health Data Research centres.
- Working with industry to facilitate trials that support the adoption of new
treatments proven to be of benefit. - Ensuring patients are involved at the heart of all future projects.
Current studies include:
PD-CRAFT2 - studying clinical and genetic risk factors for encapsulating peritoneal sclerosis. Closed early having exceeded recruitment target of 500 (NIH funded)
UK Catheter Study - providing information on which catheter insertion pathways are better. Led by Professor Martin Wilkie (Sheffield). Now closed to recruitment with 816 patients. Follow up finished and analysis commencing. Funded by NIHR.
P-DOPPS - Peritoneal Dialysis Outcomes and Practice Patterns Study - advancing the understanding of optimal practices for PD patients worldwide.
• Phase 1 (NIHR funded) complete
• Phase 2 (Kidney Research UK funded) now recruiting
PERIT-PD - Characterisation of immune response to peritonitis, develop point of care diagnostic tests (mix of funding bodies). Close to target (398/400) but may be extended.
PD HF - is peritoneal dialysis better than usual care for heart failure with CKD? Led by Cardiorenal CSG but working with PD CSG. Closed to recruitment. (BHF funded).
IMPROVE-PD - A Europe-wide consortium of universities (including Keele and Cardiff) and industry to tackle cardiovascular disease in PD patients. A broad mix of basic science and epidemiological approaches, and building future research capacity by funding 15 PhDs. (EU Horizon 2020 funded).
Got a question? Get in touch.
Get in touch
For more information and to find out about getting involved as a patient or researcher, contact: