Randomised controlled trial to determine the appropriate time to initiate peritoneal dialysis after insertion of catheter to minimise complications (Timely PD study).
BACKGROUND
The most appropriate time to initiate dialysis after surgical insertion of Tenckhoff catheters is not clear in the literature. There is the possibility of peritoneal dialysis (PD) complications such as leakage and infection if dialysis is started too soon after insertion. However, much morbidity and expense could be saved by reducing dependency on haemodialysis (HD) by earlier initiation of PD post catheter insertion. Previous studies are observational and mostly compare immediate with delayed use. The primary objective is to determine the safest and shortest time interval between surgical placement of a Tenckhoff catheter and starting PD.


METHODS
This is a randomised controlled trial of patients who will start PD after insertion of Tenckhoff catheter at Royal Brisbane and Women's Hospital (RBWH) or Rockhampton Base Hospital (RBH) who meet the inclusion criteria. Patients will be stratified by site and diabetic status. The patients will be randomised to one of three treatment groups. Group 1 will start PD one week after Tenckhoff catheter insertion, group 2 at two weeks and group 3 at four weeks. Nurses and physicians will be blinded to the randomised allocation. The primary end point is the complication rate (leaks and infection) after initiation of PD.


CONCLUSIONS
The study will determine the most appropriate time to initiate PD after placement of a Tenckhoff catheter.


BACKGROUND
ACTRN12610000076077.
Ranganathan
Dwarakanathan
D
Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia. Dwarakanathan_Ranganathan@health.qld.gov.au
Baer
Richard
R
Fassett
Robert G
RG
Williams
Nicola
N
Han
Thin
T
Watson
Melanie
M
Healy
Helen
H
D000328:Adult; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D018579:Patient Selection; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control; D011793:Queensland; D012107:Research Design; D016037:Single-Blind Method; D013997:Time Factors