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Study in End Stage Renal Disease (ESRD) Patients on Hemodialysis Comparing the Theranova Dialyzer to Hemodiafiltration

Primary Purpose

End Stage Renal Disease

Status
Completed
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Theranova 400 Dialyzer
FX800 Dialyzer
Sponsored by
Baxter Healthcare Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for End Stage Renal Disease

Eligibility Criteria

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

Inclusion Criteria:

  • Patients aged 18 years or older.
  • Patients who are able to give IC after an explanation of the proposed study.
  • Patients who have Kt/Vurea > 1.2 for the last 2 measurements, with the most recent Kt/Vurea measurement taken within 4 weeks before or during study screening.
  • Patients with a dialysis prescription (dialyzer, time, dialysis fluid flow rate (QD), blood flow rate (QB)) stable over 6 recent treatments. The dialysis treatment time should be 3.5 to 4.5 hours per session with minimum QB of at least 250 mL/min and QD of 500 mL/min.
  • Patients who are on stable anticoagulation prescription and dose.
  • Patients with ESRD receiving chronic HD treatment with a history of thrice weekly HD, and at least 1 HDF session within 1 month prior to study.
  • Patients who have been stable on in-center HD for >3 months prior to study enrollment
  • Patients who have an adequate arteriovenous (AV) fistula or graft, or dual-lumen tunneled catheter capable of providing a blood flow rate of at least 250 mL/min.
  • Patients with a minimum total convective volume (including ultrafiltration (UF)) of 16 L post-dilution for the most recent HDF treatment.
  • Patients who receive in-center treatment hemodialysis at a site that routinely implements high flux dialysis and HDF.

Exclusion Criteria:

  • Patients who have acute renal failure with the chance for recovery.
  • Patients who are pre-scheduled for a living donor kidney transplant within the next six months, who plan a change to PD within the next six months, or who require single-needle dialysis therapy.
  • Pregnant and lactating women.
  • Patients with positive serology tests for Hepatitis B surface antigen, Hepatitis C total antibody), HIV and Syphilis.
  • Patients with known hemodynamic instability, anemia (Hgb < 90 g/L), and/or patients with Hgb >130g/L for coagulation risk.
  • Patients who are severely malnourished or with significant disease that interferes with liver synthetic function, e.g. with serum albumin <35 g/L.
  • Patients with active or ongoing infection as per investigator's judgement.
  • Patients with history of solid tumors requiring anti-cancer therapy in the past or next 6 months, or life expectancy less than 1 year, or patients or with history of hematology neoplasm.
  • Patients diagnosed with a NYHA Class IV congestive heart failure, or acute coronary syndrome and/or who have suffered a myocardial infarction within three months prior to the start of the study.
  • Patients with a history of severe mental disorders.
  • Patients who are currently participating in, or have previously participated in other interventional clinical trials during the past 4 weeks.
  • Patients who have had an allergic response to polyarylethersulfone (PAES) or polysulfone (PS) membrane or have history of poor tolerance to dialyzers with synthetic membranes
  • Patients with advanced liver, heart or pulmonary disease as judged by the Investigator.
  • Patients with any comorbidity possibly conflicting with the study purpose or procedures as judged by the Investigator.

Sites / Locations

  • Baxter Investigational Site
  • Baxter Investigational Site
  • Baxter Investigational Site
  • Baxter Investigational Site
  • Baxter Investigational Site
  • Baxter Investigational Site
  • Baxter Investigational Site
  • Baxter Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Theranova 400 Dialyzer

FX800

Arm Description

In-center hemodialysis (in HD mode), 3 times a week for 12 week duration. The patient will undergo regular HD treatment on the first treatment of the first week of study, after which, the patient will switch to the randomized dialyzer, from the second treatment to the end of study treatment. Blood sampling will be obtained at the hospital by trained personnel according to local routines.

In-center hemodialysis (in HDF mode), 3 times a week for 12 week duration. The patient will undergo regular HD treatment on the first treatment of the first week of study, after which, the patient will switch to the randomized dialyzer, from the second treatment to the end of study treatment. Blood sampling will be obtained at the hospital by trained personnel according to local routines.

Outcomes

Primary Outcome Measures

Reduction ratio of lambda free light chains (λ FLC)
At the first mid-week treatment day
Reduction ratio of β2 microglobulin
At the first mid-week treatment day
Pre-dialysis serum albumin

Secondary Outcome Measures

Kt/V urea
Mid-Week Treatment Day
Urea reduction ratio (URR)
Mid-Week Treatment Day
Pre-dialysis serum levels of λ FLC
Mid-Week Treatment Day
Pre-dialysis serum levels of β2 microglobulin
Mid-Week Treatment Day
Reduction ratio of α1 microglobulin (α1M)
At the first mid-week treatment day
Reduction ratio of Chitinase-3-like protein (YKL-40)
At the first mid-week treatment day
Reduction ratio of complement factor D (CFD)
At the first mid-week treatment day
Reduction ratio of myoglobin
At the first mid-week treatment day
Reduction ratio of kappa free light chains (κ FLC)
At the first mid-week treatment day

Full Information

First Posted
May 16, 2018
Last Updated
March 2, 2020
Sponsor
Baxter Healthcare Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT03547336
Brief Title
Study in End Stage Renal Disease (ESRD) Patients on Hemodialysis Comparing the Theranova Dialyzer to Hemodiafiltration
Official Title
A Randomized, Controlled, Open-label, Parallel Study in End Stage Renal Disease (ESRD) Patients on Hemodialysis Comparing the Theranova Dialyzer to Hemodiafiltration
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
June 29, 2018 (Actual)
Primary Completion Date
January 4, 2020 (Actual)
Study Completion Date
January 4, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baxter Healthcare Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In China, the estimated prevalence of patients with ESRD receiving PD or maintenance HD increased from 51.7 per million population (pmp) at the end of 2007 to 79.1 pmp at the end of 2008. Theranova 400 is designed to deliver the performance of hemodiafiltration (HDF) using standard hemodialysis (HD) equipment and treatment mode, including HD machines, disposables, blood and dialysate flows, length of treatment and frequency of treatment. Theranova 400 utilizes a Medium Cut-Off (MCO) membrane with extended permeability for middle solutes to closely modulate the removal function of the kidney without the complexity of HDF. The primary objective of the study is to demonstrate non-inferiority of the Theranova Dialyzer in hemodialysis (HD) mode compared to hemodiafiltration (HDF), using FX 800 in HDF mode. Comparison of the study arms over time will be used to support the safety of Theranova 400 by demonstrating stable serum albumin levels, as well as support the dialyzer's efficacy to significantly remove serum middle molecules.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End Stage Renal Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
212 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Theranova 400 Dialyzer
Arm Type
Experimental
Arm Description
In-center hemodialysis (in HD mode), 3 times a week for 12 week duration. The patient will undergo regular HD treatment on the first treatment of the first week of study, after which, the patient will switch to the randomized dialyzer, from the second treatment to the end of study treatment. Blood sampling will be obtained at the hospital by trained personnel according to local routines.
Arm Title
FX800
Arm Type
Active Comparator
Arm Description
In-center hemodialysis (in HDF mode), 3 times a week for 12 week duration. The patient will undergo regular HD treatment on the first treatment of the first week of study, after which, the patient will switch to the randomized dialyzer, from the second treatment to the end of study treatment. Blood sampling will be obtained at the hospital by trained personnel according to local routines.
Intervention Type
Device
Intervention Name(s)
Theranova 400 Dialyzer
Intervention Description
Dialysis performed in HD mode. Treatment duration for each individual subject will vary based on clinical requirements determined by the Investigator, based on the subject's need, residual renal function, access function, tolerance to HD/HDF and other relevant factors. The participating subjects' HD/HDF prescriptions should be kept stable throughout the study.
Intervention Type
Device
Intervention Name(s)
FX800 Dialyzer
Intervention Description
Dialysis performed in HDF mode. Treatment duration for each individual subject will vary based on clinical requirements determined by the Investigator, based on the subject's need, residual renal function, access function, tolerance to HD/HDF and other relevant factors. The participating subjects' HD/HDF prescriptions should be kept stable throughout the study.
Primary Outcome Measure Information:
Title
Reduction ratio of lambda free light chains (λ FLC)
Description
At the first mid-week treatment day
Time Frame
Up to 1 week
Title
Reduction ratio of β2 microglobulin
Description
At the first mid-week treatment day
Time Frame
Up to 1 week
Title
Pre-dialysis serum albumin
Time Frame
Study Completion (Week 12)
Secondary Outcome Measure Information:
Title
Kt/V urea
Description
Mid-Week Treatment Day
Time Frame
Week 1, Week 5, Week 9, Week 13
Title
Urea reduction ratio (URR)
Description
Mid-Week Treatment Day
Time Frame
Week 1, Week 5, Week 9, Week 13
Title
Pre-dialysis serum levels of λ FLC
Description
Mid-Week Treatment Day
Time Frame
Week 1, Week 5, Week 9, Week 13
Title
Pre-dialysis serum levels of β2 microglobulin
Description
Mid-Week Treatment Day
Time Frame
Week 1, Week 5, Week 9, Week 13
Title
Reduction ratio of α1 microglobulin (α1M)
Description
At the first mid-week treatment day
Time Frame
Up to 1 week
Title
Reduction ratio of Chitinase-3-like protein (YKL-40)
Description
At the first mid-week treatment day
Time Frame
Up to 1 week
Title
Reduction ratio of complement factor D (CFD)
Description
At the first mid-week treatment day
Time Frame
Up to 1 week
Title
Reduction ratio of myoglobin
Description
At the first mid-week treatment day
Time Frame
Up to 1 week
Title
Reduction ratio of kappa free light chains (κ FLC)
Description
At the first mid-week treatment day
Time Frame
Up to 1 week

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients aged 18 years or older. Patients who are able to give IC after an explanation of the proposed study. Patients who have Kt/Vurea > 1.2 for the last 2 measurements, with the most recent Kt/Vurea measurement taken within 4 weeks before or during study screening. Patients with a dialysis prescription (dialyzer, time, dialysis fluid flow rate (QD), blood flow rate (QB)) stable over 6 recent treatments. The dialysis treatment time should be 3.5 to 4.5 hours per session with minimum QB of at least 250 mL/min and QD of 500 mL/min. Patients who are on stable anticoagulation prescription and dose. Patients with ESRD receiving chronic HD treatment with a history of thrice weekly HD, and at least 1 HDF session within 1 month prior to study. Patients who have been stable on in-center HD for >3 months prior to study enrollment Patients who have an adequate arteriovenous (AV) fistula or graft, or dual-lumen tunneled catheter capable of providing a blood flow rate of at least 250 mL/min. Patients with a minimum total convective volume (including ultrafiltration (UF)) of 16 L post-dilution for the most recent HDF treatment. Patients who receive in-center treatment hemodialysis at a site that routinely implements high flux dialysis and HDF. Exclusion Criteria: Patients who have acute renal failure with the chance for recovery. Patients who are pre-scheduled for a living donor kidney transplant within the next six months, who plan a change to PD within the next six months, or who require single-needle dialysis therapy. Pregnant and lactating women. Patients with positive serology tests for Hepatitis B surface antigen, Hepatitis C total antibody), HIV and Syphilis. Patients with known hemodynamic instability, anemia (Hgb < 90 g/L), and/or patients with Hgb >130g/L for coagulation risk. Patients who are severely malnourished or with significant disease that interferes with liver synthetic function, e.g. with serum albumin <35 g/L. Patients with active or ongoing infection as per investigator's judgement. Patients with history of solid tumors requiring anti-cancer therapy in the past or next 6 months, or life expectancy less than 1 year, or patients or with history of hematology neoplasm. Patients diagnosed with a NYHA Class IV congestive heart failure, or acute coronary syndrome and/or who have suffered a myocardial infarction within three months prior to the start of the study. Patients with a history of severe mental disorders. Patients who are currently participating in, or have previously participated in other interventional clinical trials during the past 4 weeks. Patients who have had an allergic response to polyarylethersulfone (PAES) or polysulfone (PS) membrane or have history of poor tolerance to dialyzers with synthetic membranes Patients with advanced liver, heart or pulmonary disease as judged by the Investigator. Patients with any comorbidity possibly conflicting with the study purpose or procedures as judged by the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Baxter Clinical Trial
Organizational Affiliation
Baxter Healthcare
Official's Role
Study Director
Facility Information:
Facility Name
Baxter Investigational Site
City
Hefei
State/Province
Anhui
ZIP/Postal Code
230601
Country
China
Facility Name
Baxter Investigational Site
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510515
Country
China
Facility Name
Baxter Investigational Site
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450052
Country
China
Facility Name
Baxter Investigational Site
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430060
Country
China
Facility Name
Baxter Investigational Site
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200011
Country
China
Facility Name
Baxter Investigational Site
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610041
Country
China
Facility Name
Baxter Investigational Site
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310014
Country
China
Facility Name
Baxter Investigational Site
City
Beijing
ZIP/Postal Code
100034
Country
China

12. IPD Sharing Statement

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Study in End Stage Renal Disease (ESRD) Patients on Hemodialysis Comparing the Theranova Dialyzer to Hemodiafiltration

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