Research is supported to address fundamental problems involving PD. Projects involving cooperation amongst sites is encouraged. Request for grants will be announced when funding is available. For further information, please contact the chair of the Research Committee.
The establishment of the ISPD North American Chapter Research Consortium (NARC) in Nashville in May 2013 is a landmark event for ISPD NAC. A consensus was reached that the first NARC project would be a prospective multicenter study looking at peritoneal catheter insertion in the U.S. and Canada. The notion was that results with peritoneal catheter insertion were hugely variable across the two countries with some centers having mediocre outcomes in terms of endpoints like primary catheter function, infection and drain pain. It was thought that assessing the extent of these problems would be a first step towards setting realistic standards and improving outcomes This was thought to be particularly important during a period when PD was likely to expand in use due to funding initiatives in both countries.
After the meeting, a request for submissions of interest in participating in and in leading the proposed catheter study was sent out to all NAC members and to all attendees at the Nashville conference. More than 40 centers with over 1200 catheter insertions annually expressed interest in participating. A number also expressed interest in playing a leadership role and after peer review the proposal form Rob Quinn of Calgary and Matt Oliver of Toronto was accepted. A collaboration was then set up between these 2 investigators and a US group from Nashville and Birmingham, Alabama led by Rachel Fissell, Eric Wallace and Francesca Tentori. Both Francesca and Rachel hare also key members of DOPPS and are involved in the PDOPPS initiative. The combined proposal has now been put together and some initial funding has been secured from Baxter Global. Other sources of funding will be sought. It is hoped that he study will begin in the first half of 2014.
North American Research Consortium in Peritoneal Dialysis (NARC-PD)
At the Nashville NAC meeting in June of 2013 the chapter agreed to form the North American Research Consortium in Peritoneal Dialysis (NARC-PD). The first study is observational and intending to define best catheter placement and early management strategies, under the direction of Rob Quinn and Matt Oliver, with close association with Eric Wallace, Rachel Fissell, Francesco Tentori, and Jeff Perl. This project was selected for its relative ease of performance and to establish the data collection tools/methods needed for a successful transcontinental consortium.
A research committee composed of Mike Flessner, Sharon Nessim, Jeff Perl, Jimmie Pirkle, Francesca Tentori and Eric Wallace, chaired by Tom Golper has the duty to first define and prioritize the future scientific studies that NARC will address, and to further enhance its success by recommending organizational and financial considerations. It answers to the NAC Executive Committee/Council
The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is designed to advance the understanding of optimal practices for PD patients worldwide and to reduce barriers to PD use. Our hope is that the study will increase the appropriate use of PD, extend technique survival, and improve quality of life for PD patients.
Full details are provided on the home page of the ISPD website (Giorgia Can we do a link here?). PDOPPS is very relevant to ISPD NAC and NARC. First, PDOPPS is co-ordinated from Ann Arbor, Michigan and many NAC members are very involved. Jeff Perl, a member of our NAC Exec is taking a leadership role in PDOPPS as is Francesca Tentori from Nashville.
Already a number of Canadian sites in Toronto and In London, Ontario are up and going as PDOPPS centers. U.S. sites will soon also join. A number of research questions have been identified.
IMPENDIA published in JASN
CLICK HERE to read the study
Congratulations to NAC members involved in the IMPENDIA randomized controlled trial, the results of which were published in the November 2013 issue of JASN. Authors include ISPD President and NAC member, Joanne Bargman, Mauro Verrelli from Winnipeg, Bruce Culleton, Ty Shockley and Ken Story from Baxter and a numerous other collaborators. The study is one of the largest randomized trials ever done in the area of PD solutions and, if we include the closely associated EDEN trial, 251 PD patients in 11 different countries were enrolled.
The primary question was whether glucose sparing PD solution regimens comprising icodextrin and amino acids could give improved metabolic outcomes compared to control solutions. The study did show significant benefits in the form of lower glycated hemoglobin and lipid levels but there was an unexpected excess of adverse outcomes related to fluid overload in those receiving the glucose sparing regimen. These findings are certainly going to stimulate discussion.