North America Chapter Research

North American Research Consortium (NARC-PD)

Entries are organized starting with the latest updates.

Lead Investigators:

▪️Matthew Oliver (Sunybrook Hospital, Toronto, ON);
▪️Rob Quinn (University of Calgary, Calgary, AB).

2026 update coming soon!

October 2017 update:

The PD Catheter Registry was successfully launched in January 2016 by the North American Chapter of the ISPD Research Consortium. Currently there are eight renal programs across North America contributing data to the PD Catheter Registry with 6 renal programs expected to join by the end of the year.

The PD Catheter Registry is an interactive web-based system that collects patient information to identify key variables that affect PD catheter performance. The registry provides user training, on-line coaching and expert review of all data entered. The complications that are tracked include inflow/outflow restrictions, leaks, drain pain, bleeding, hernias, and infections. We provide interested programs an easy to use method measure program performance and opportunities to participate in high impact research.

For further information:
▪️Visit the registry website;
▪️Contact Dr. Matthew Oliver.

April 2016 update:

There is strong interest across dialysis programs in North America to participate in a registry for peritoneal dialysis catheters, as evidenced by the completion of the survey and sites expressing interest in joining the project. Most programs participate in some form of local quality improvement, but there is wide variability in practices and a lack of standardized definitions. Further, best practices are not based on actual program performance measured by an independent system.

Experts in the field have identified key variables that may determine outcomes but there must be strong engagement of the operators (surgeons, radiologists, nephrologists, and advance practiced nurses) who insert peritoneal dialysis catheters in order to capture this information. Outcomes should be defined by using objective measures and diagnostic criteria in order to facilitate data alignment (e.g., P-DOPPS) and clear definitions. Important outcomes to track include inflow/outflow problems, infections, bleeding, leaks, drain pain and extruded cuffs or other damage to catheters. We also have to be sensitive to privacy issues using data anonymization and controlling access to the data contained in the registry.

We have built a demonstration version of the registry, which is currently undergoing testing. Research agreements are being established to transfer data to the Sunnybrook Research Institute. We have analyzed pilot data which demonstrates a significant portion of patients had at least one complication related to their catheter. One third of patients have had to stop peritoneal dialysis at least temporarily as a result of these complications. Data from other programs is now required to determine how widespread this problem is and identify potential ways of addressing it.

Publication:
Catheter Insertion and Perioperative Practices Within the ISPD North American Research Consortium, 2016 [LINK]

August 2014 letter from NAC Leadership to the Peritoneal Catheter Study’s participants:

Dear colleagues,

I hope that you have all had an enjoyable summer.

We would like to thank all of you who provided additional feedback about our planned research and quality improvement initiatives through the ISPD North American Research Consortium. We would also like to announce that the Survey of PD Catheter Practices has been finalized and that you will have received an email containing important information about completing the survey today. It has taken a couple of weeks longer than planned so that we could incorporate the feedback that we’ve received to date.

We would strongly encourage you to review the pdf version of the survey that was circulated with the email before attempting to complete it. There are questions that may require some preliminary work or input from nursing and surgical colleagues. It will be important to have that information at hand when you click on the link so that you are able to respond to the survey questions. You will not be able to save your information part way through.

Thank you in advance for agreeing to participate and taking the time to complete the survey. It’s an important first step in identifying variation in practice, refining proposed research and quality improvement activities, and preparing for funding applications. We look forward to sharing the results when they are available.

Sincerely,

Dr. Rob Quinn and Dr. Matthew Oliver on behalf of the ISPD North American Research Consortium Steering Committee – Dr. Eric Wallace, Dr. Tom Golper, Dr. Rachel Fissell, Dr. Adriana Hung, Dr. Francesca Tentori, and Dr. Peter Blake.

July 2014 update from the Advisory Group:

Following the Nashville meeting organized by Dr. Tom Golper in the spring of 2013 a formal call for research proposals was issued by the ISPD NAC and on August 31, 2013 deadline was set for submission. Dr. Matthew Oliver and Dr. Rob Quinn were asked to co-lead a project focusing on improving PD catheter outcomes in collaboration with Dr. Tom Golper, Dr. Eric Wallace, Dr. Adriana Hung, Dr. Rachel Fissell, and Dr. Francesca Tentori.

The overarching goals of this project are to quantify the variability in PD catheter practices and outcomes in North American programs, identify key predictors of successful PD catheter outcomes, and establish a sustainable framework for ongoing quality improvement relating to PD catheter practices. This work will lay the foundation for large, multi-center, multi-national randomized controlled trials by identifying key research priorities and establishing a research network with the size and expertise to conduct them. It will also establish a sustainable model of quality improvement that facilitates benchmarking of local practice and outcomes against other programs. The vision is to make the ISPD-NAC unique as an organization that not only produces practice recommendations, but also actively participates in generating new science and providing programs with the tools required to monitor and improve their performance.

The current project has 3 main objectives:
▪️To perform a survey of participating centers regarding PD catheter insertion practices to identify variation in practice and to guide development of data collection tools and a framework for quality improvement;
▪️To identify important predictors of PD catheter failure with a specific focus on method of PD catheter insertion (open, laparoscopic, percutaneous), post-insertion care (flushing of catheter), and buried vs. non-buried catheters;
▪️To develop a sustainable framework for ongoing quality improvement at the program level relating to PD catheter practices, determine the variability in PD catheter outcomes across programs, and identify high-performing sites.

Sites willing to participate in the North American Research Consortium were asked to declare their interest and the response was overwhelming. Thank you to the approximately 40 sites from Canada and the United States that have indicated their willingness to support the project.

A proposal was drafted and submitted to Baxter Corporation requesting start-up funds at the end of November 2013. Baxter generously agreed to provide these funds to the ISPD-NAC in support of the PD catheter project early in 2014.

Since that time, an ISPD-NAC Advisory Group was formed to oversee the project that includes Dr. Peter Blake in addition to the investigators listed above. Regular teleconferences were organized to move the project along and have made considerable progress.

The ISPD-NAC Advisory Group has:
▪️Identified potential sources of funding from local, regional, and national funding agencies in Canada and the United States. The Advisory Group is currently preparing grant applications for these opportunities to secure funding to conduct the studies;
▪️Drafted the survey of participating centers. This will be circulated to member sites soon;
▪️Developed a study protocol and data dictionary and is currently working on finalizing the data collection platform;
▪️The Advisory Group is also in discussions with dialysis providers to determine how best to collect quality improvement data at participating sites.

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.

The NAC Research Committee 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.

Peritoneal Dialysis Outcomes and Practice Patterns (PDOPPS)

Entries are organized starting with the latest updates.

Lead Investigators:

▪️Jeffrey Perl (St. Michael’s Hospital, Toronto, ON);
▪️Bruce Robinson (Arbor Research Institute, Ann Arbor, MI).

2026 update coming soon!

April 2016 update:

The international Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) project is the largest international prospective cohort study of practice of peritoneal dialysis and outcomes with the therapy, developed in close collaboration between the International Society for Peritoneal Dialysis (ISPD) and Arbor Research Collaborative for Health (Ann Arbor, Michigan, USA). Launched in 2012, the PDOPPS is a groundbreaking research initiative for understanding and advancing peritoneal dialysis therapy and determining optimal practices for peritoneal dialysis patients worldwide. Continuing the DOPPS mission of improving outcomes and care for dialysis patients, the PDOPPS conducts clinical research to promote the appropriate use of peritoneal dialysis, extend technique survival, and improve quality of life for patients undergoing peritoneal dialysis.

The pilot study launched in October 2013, with longitudinal data collection starting in Canada and the United States in January 2014. The PDOPPS quickly expanded to Japan by late 2014, and Australia, New Zealand, and the United Kingdom joined the study in 2015, with plans to initiate in Thailand in the first half of 2016. Across the six participating countries where data collection is underway, the study has already enrolled over 4000 patients across 180 participating study sites. In the USA, PDOPPS will also soon be expanding to include representation from all large dialysis organizations including DaVita Healthcare which has recently joined the study, with a target recruitment of 100 facilities in the USA. In Canada, the study is entering its third year with representation from 20 facilities and the recruitment of 755 patients to date.

For further information:
▪️Visit this website.

Publication:
The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis, 2016 [LINK]

PDOPPS Initiative

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.

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.

Geriatric Assessment for Patients Starting Peritoneal Dialysis

Lead Investigators:

▪️Vanita Jassal (University Health Network, Toronto, ON);
▪️Matthew Oliver (Sunybrook Hospital, Toronto, ON).

April 2016 update:

Peritoneal dialysis is being promoted to increase the use of home dialysis, reduce reliance on in-center hemodialysis, and decrease the cost for the treatment of end-stage renal disease. However as the population ages, more individuals have barriers to self-care and therefore need assistance to receive peritoneal dialysis in their homes.

This project is designed to better understand the practical impact of patient-related factors such as frailty, physical function and cognitive impairment, on the ability to manage individual self-care tasks required for peritoneal dialysis care.

The specific aims of this proposal are:
1) to determine the feasibility of conducting a comprehensive geriatric assessment as part of assessment for patients for peritoneal dialysis;
2) to determine the type and quantity of assistance required by older patients undergoing peritoneal dialysis;
3) to assess the degree and direction of changes in the level of independence with peritoneal dialysis related tasks over time.

To date, the project has recruited 128 patients, aged ≥ 65 years at the time of dialysis initiation, across three large peritoneal dialysis centers in Ontario. The comprehensive geriatric assessment was feasible in 96% of patients at baseline. Approximately 40% of patients have completed the 6-month follow up study period, while the majority continue to be followed. Of those who have completed the study, patients have an average of 4 follow up assessments over the 6 month period. Follow up assessments include a detailed evaluation of which tasks related to peritoneal dialysis are being done by the patient, which are delegated to a caregiver or family member and which require formal assistance from a paid care provider. Preliminary data suggest a high, but stable burden of functional dependence amongst those starting peritoneal dialysis. Assistance is often given at the onset of the treatment, however several patients also report that they perceive being able to independently perform the task were they required to.

IMPENDIA published in JASN

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.

Publication:

The IMPENDIA-EDEN Study, 2013 [LINK]

ISPD NAC Research Award 2026

Aim

• This award aims to stimulate research and to support the next generation of home dialysis researchers.

The 2026 ISPD-NAC research award is supported by PDOPPS.

Application deadline extended to April 8th!

Information

• Application deadline: April 1st, 2026
• Email: ispdnac@gmail.com
• Start date: July 1st, 2026

Applications will be reviewed and ranked by at least 2 members of the ISPD-NAC Research committee or executive.

Award details

• Up to $3,000 USD to cover airfare, hotel accommodations and meeting registration to present findings at one of: The American Society of Nephrology Kidney Week, Annual Dialysis Conference, National Kidney Foundation Spring Clinical Meetings.
• Access to PDOPPS data and statistical support.
• A research project will be assigned to the awardee by the PDOPPS team with consideration of the awardee’s expertise and interests.

Candidate details

• Nephrology fellow in the United States or Canada with dedicated research time.
• 12-month engagement.
• Strong interest in pursuing home dialysis research in their future career.
• ISPD member (join [HERE] or renew [HERE]).

Information needed to apply

• Curriculum Vitae.
• A letter outlining their academic background and motivation for receiving this award.
• Letter of support from their fellowship director, including proportion of time dedicated to research.
• Letter of reference from their previous or current supervisor.