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Feasibility Study for Heparin-free Hemodialysis With the Dialyzer With Endexo™

Primary Purpose

Chronic Kidney Diseases, Patient Requiring Heparin Free Dialysis Treatments

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Dialyzer with Endexo
Sponsored by
Fresenius Medical Care North America
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Chronic Kidney Diseases

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Must be an adult, defined as having had a 22nd birthday on or before the date of signed informed consent
  2. Has been prescribed in center thrice weekly HD for at least 180 days prior to the date of signed informed consent
  3. Has been on Conventional HD for at least 30 days prior to the date of signed informed consent. Conventional HD includes: Optiflux dialyzer (F160NR or F180NR), standard of care (SOC) bloodline, Citrasate dialysate, and regularly prescribed heparin dose.
  4. Has a prescribed HD treatment duration ≥ 180 minutes (3 hours) and ≤ 270 minutes (4.5 hours) at the time of signed informed consent
  5. Has a well-established functional permanent vascular access (AVF, AVG) that can allow a blood flow of at least 250 mL/min
  6. Has been on a regularly prescribed heparin dose for HD and has had no change in heparin prescription within 14 days prior to the date of signed informed consent
  7. Has the following most recently available laboratory results within 45 days prior to the date of signed informed consent:

    1. Single pool Kt/V (spKt/V) ≥ 1.2
    2. Hemoglobin ≥ 9 g/dL
    3. Platelet count ≥ 100,000/mm3
  8. A female of childbearing potential must have a negative serum pregnancy test at the time of screening and agree to use an acceptable method of contraception during the study

Exclusion Criteria:

  1. Known allergic reactions to Endexo
  2. Known heparin contraindications
  3. Hospitalization within 30 days prior to the date of signed informed consent
  4. Presence of active malignancy, congestive heart failure New York Heart Association (NYHA) Class III or IV (see Appendix II. A New York Heart Association Functional Classification), or liver cirrhosis
  5. Is receiving or has received chemotherapy/radiation therapy/immunotherapy/plasmapheresis therapy within 90 days prior to the date of signed informed consent
  6. Is receiving oral or/and intravenous (IV) antibiotics or has used oral or/and IV antibiotics within 14 days prior to the date of signed informed consent
  7. Is currently enrolled in or has completed any other investigational product study within 30 days prior to the date of signed informed consent
  8. Is receiving anticoagulants including vitamin K antagonists
  9. Is receiving a glycoprotein platelet inhibitor
  10. Is receiving more than one anti-platelet medication
  11. Is receiving systemic heparin therapy for prevention or treatment besides heparin prescribed for dialysis
  12. Requiring blood and other labile blood products (for e.g., fresh frozen plasma, platelets) transfusion during HD treatments
  13. Has history of clotting or bleeding disorders
  14. Has history or current evidence of any condition, therapy, or laboratory abnormality that might interfere with the participant's ability to follow the requirements of the study and participate for the full duration of the study, or is not in the best interest of the subjects to participate, in the opinion of the investigator.

Sites / Locations

  • Fresenius Kidney Care Craven County Dialysis Center
  • New Bern Dialysis Unit

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Sequence AB: circuit A follow by circuit B

Sequence BA: circuit B follow by circuit A

Arm Description

Circuit (A) includes the dialyzer with Endexo and the CombiSet bloodline Circuit (B) includes dialyzer with Endexo and the Streamline bloodline

Circuit (B) includes dialyzer with Endexo and the Streamline bloodline Circuit (A) includes the dialyzer with Endexo and the CombiSet bloodline

Outcomes

Primary Outcome Measures

The Primary Endpoint is the Number and Percent (%) of Successful Heparin-free HD Sessions for Each Subject in Each Circuit.
Each participant was expected to receive 3 heparin-free HD sessions. The number and percentage of successful HD sessions were derived based on the 3 heparin-free HD sessions for each participant in each circuit. A successful HD session must meet all the following criteria: Absence of complete HD circuit occlusion (Grade 4) rendering dialysis impossible Absence of the need to replace dialyzers or bloodlines due to clotting Absence of saline flushes to maintain blood flow through the circuit during the HD session Absence of any additional heparin beyond what is allowed per study visits Single pool Kt/V (spKt/V) ≥ 1.2

Secondary Outcome Measures

The Secondary Endpoints Include Adverse Events .
The number of Serious Adverse Events and Adverse Events during the study periods
The Secondary Endpoints Include Device-related Adverse Events.
All device-related serious adverse events and adverse events occurred during the study periods

Full Information

First Posted
August 7, 2020
Last Updated
March 2, 2022
Sponsor
Fresenius Medical Care North America
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1. Study Identification

Unique Protocol Identification Number
NCT04511338
Brief Title
Feasibility Study for Heparin-free Hemodialysis With the Dialyzer With Endexo™
Official Title
A Randomized, Open Label, Cross-over Feasibility Study for Heparin-free Hemodialysis With the Dialyzer With Endexo™ in End-Stage Renal Disease (ESRD) Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
November 2, 2020 (Actual)
Primary Completion Date
May 21, 2021 (Actual)
Study Completion Date
June 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fresenius Medical Care North America

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes

5. Study Description

Brief Summary
This study will assess the safety and efficacy of heparin free hemodialysis (HD) performed with dialyzers with Endexo in adult end-stage renal disease (ESRD) subjects on thrice-weekly in-center HD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Diseases, Patient Requiring Heparin Free Dialysis Treatments

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sequence AB: circuit A follow by circuit B
Arm Type
Experimental
Arm Description
Circuit (A) includes the dialyzer with Endexo and the CombiSet bloodline Circuit (B) includes dialyzer with Endexo and the Streamline bloodline
Arm Title
Sequence BA: circuit B follow by circuit A
Arm Type
Experimental
Arm Description
Circuit (B) includes dialyzer with Endexo and the Streamline bloodline Circuit (A) includes the dialyzer with Endexo and the CombiSet bloodline
Intervention Type
Device
Intervention Name(s)
Dialyzer with Endexo
Intervention Description
Sequence AB: Period 1 Circuit A (Five Visits: 1,2,3,4,5) Period 2 Circuit B (Five Visits: 9,10,11,12,13) Sequence BA: Period 1 Circuit B (Five Visits: 1,2,3,4,5) Period 2 Circuit A (Five Visits: 9,10,11,12,13)
Primary Outcome Measure Information:
Title
The Primary Endpoint is the Number and Percent (%) of Successful Heparin-free HD Sessions for Each Subject in Each Circuit.
Description
Each participant was expected to receive 3 heparin-free HD sessions. The number and percentage of successful HD sessions were derived based on the 3 heparin-free HD sessions for each participant in each circuit. A successful HD session must meet all the following criteria: Absence of complete HD circuit occlusion (Grade 4) rendering dialysis impossible Absence of the need to replace dialyzers or bloodlines due to clotting Absence of saline flushes to maintain blood flow through the circuit during the HD session Absence of any additional heparin beyond what is allowed per study visits Single pool Kt/V (spKt/V) ≥ 1.2
Time Frame
Approximately 5 weeks, Period 1: two weeks with either Circuit A or Circuit B; Washout: 1 week; Period 2: two weeks with the circuit other than Period 1.
Secondary Outcome Measure Information:
Title
The Secondary Endpoints Include Adverse Events .
Description
The number of Serious Adverse Events and Adverse Events during the study periods
Time Frame
two weeks each period (10 weeks per subject: 4 weeks for screening, 2 weeks for Period 1, 1 week for Washout, and 2 weeks for Period 2)
Title
The Secondary Endpoints Include Device-related Adverse Events.
Description
All device-related serious adverse events and adverse events occurred during the study periods
Time Frame
two weeks each period (10 weeks per subject: 4 weeks for screening, 2 weeks for Period 1, 1 week for Washout, and 2 weeks for Period 2)
Other Pre-specified Outcome Measures:
Title
Number and Percentage of Dialyzers and Blood Lines for Each Clotting Grade Using the Visual Inspection Clotting Grade Scale
Description
Number and percentage of dialyzers (arterial end cap, venous end cap) and blood lines (CombiSet: Arterial chamber, venous chamber; Streamline: Arterial pod, venous pod, venous chamber) for each clotting grade using the visual inspection clotting grade scale
Time Frame
Approximately 5 weeks
Title
HD Treatment Duration or Time to Complete Circuit Occlusion (Grade 4)
Description
HD treatment duration or time to complete circuit occlusion (Grade 4). The treatment duration was recorded for each HD session.
Time Frame
Approximately 4.5 hours
Title
Blood Volume Processed for Heparin Free
Description
Blood volume processed (BVP) for each of 3 heparin free HD sessions (expected). The average of BVPs for each subject was calculated first then the descriptive stat. were derived.
Time Frame
Approximately 4.5 hours for each HD session
Title
The Volume of Saline Administered Per Subject Per HD Session (Other Than for Circuit Priming or Rinse Back).
Description
The volume of saline administered per subject per HD session (other than for circuit priming or rinse back). The total volume was calculated for each HD session.
Time Frame
Approximately 4.5 hours
Title
The Time of Saline Administered Per Subject Per HD Session (Other Than for Circuit Priming or Rinse Back).
Description
The time of saline administered per subject per HD session (other than for circuit priming or rinse back) during a HD session.
Time Frame
Approximately 4.5 hours
Title
The Reason for Saline Administration Per Subject Per HD Session (Other Than for Circuit Priming or Rinse Back).
Description
to determine if a HD was successful. When saline was used for maintaining blood flow or treating clotting, the heparin free HD was not successful.
Time Frame
Approximately 4.5 hours
Title
Urea Reduction Ratio (URR) for All HD Sessions
Description
to assess the adequacy of each dialysis session
Time Frame
Approximately 5 weeks
Title
spKt/V for All HD Sessions
Description
to assess the dialysis adequacy of each HD session
Time Frame
2 weeks for each period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must be an adult, defined as having had a 22nd birthday on or before the date of signed informed consent Has been prescribed in center thrice weekly HD for at least 180 days prior to the date of signed informed consent Has been on Conventional HD for at least 30 days prior to the date of signed informed consent. Conventional HD includes: Optiflux dialyzer (F160NR or F180NR), standard of care (SOC) bloodline, Citrasate dialysate, and regularly prescribed heparin dose. Has a prescribed HD treatment duration ≥ 180 minutes (3 hours) and ≤ 270 minutes (4.5 hours) at the time of signed informed consent Has a well-established functional permanent vascular access (AVF, AVG) that can allow a blood flow of at least 250 mL/min Has been on a regularly prescribed heparin dose for HD and has had no change in heparin prescription within 14 days prior to the date of signed informed consent Has the following most recently available laboratory results within 45 days prior to the date of signed informed consent: Single pool Kt/V (spKt/V) ≥ 1.2 Hemoglobin ≥ 9 g/dL Platelet count ≥ 100,000/mm3 A female of childbearing potential must have a negative serum pregnancy test at the time of screening and agree to use an acceptable method of contraception during the study Exclusion Criteria: Known allergic reactions to Endexo Known heparin contraindications Hospitalization within 30 days prior to the date of signed informed consent Presence of active malignancy, congestive heart failure New York Heart Association (NYHA) Class III or IV (see Appendix II. A New York Heart Association Functional Classification), or liver cirrhosis Is receiving or has received chemotherapy/radiation therapy/immunotherapy/plasmapheresis therapy within 90 days prior to the date of signed informed consent Is receiving oral or/and intravenous (IV) antibiotics or has used oral or/and IV antibiotics within 14 days prior to the date of signed informed consent Is currently enrolled in or has completed any other investigational product study within 30 days prior to the date of signed informed consent Is receiving anticoagulants including vitamin K antagonists Is receiving a glycoprotein platelet inhibitor Is receiving more than one anti-platelet medication Is receiving systemic heparin therapy for prevention or treatment besides heparin prescribed for dialysis Requiring blood and other labile blood products (for e.g., fresh frozen plasma, platelets) transfusion during HD treatments Has history of clotting or bleeding disorders Has history or current evidence of any condition, therapy, or laboratory abnormality that might interfere with the participant's ability to follow the requirements of the study and participate for the full duration of the study, or is not in the best interest of the subjects to participate, in the opinion of the investigator.
Facility Information:
Facility Name
Fresenius Kidney Care Craven County Dialysis Center
City
New Bern
State/Province
North Carolina
ZIP/Postal Code
28560
Country
United States
Facility Name
New Bern Dialysis Unit
City
New Bern
State/Province
North Carolina
ZIP/Postal Code
28560
Country
United States

12. IPD Sharing Statement

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Feasibility Study for Heparin-free Hemodialysis With the Dialyzer With Endexo™

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