When to give dialysis before surgery in kidney failure patients

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This pilot trial compares two preoperative dialysis schedules in adults with end-stage kidney disease who are undergoing nonemergent surgery. Participants are randomized to receive same-day hemodialysis or not on the day of surgery, with follow-up including up to 4 weeks before and after surgery and assessment of 30-day outcomes. The study aims to determine feasibility and safety of the scheduling approach, and to characterize perioperative health in the two arms over roughly two months. The investigation is conducted within the Stanford Health Care system, with collaboration from NIDDK, and uses usual dialysis practices to maintain a stable regimen prior to enrollment.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Patient is willing to comply with all study procedures for the duration of the study
2. Patient has a diagnosis of ESKD
3. Patient initiated hemodialysis at least 90 days prior to the planned surgical procedure
4. Patient is treated with a stable hemodialysis schedule, defined as an average of 2.5- 3.5 hemodialysis sessions per week in the preceding 4 weeks prior to surgery
5. Patient is scheduled to undergo nonemergent surgical procedures in the Stanford Health Care system. This includes (but is not limited to):

   * Fistula or graft creation, revision, or removal
   * Fistulogram
   * Peritoneal dialysis catheter placement or revision
   * Lower extremity angiogram (including femoral and iliac vessels)
   * Lower extremity bypass (including femoral and iliac vessels)
   * Lower extremity amputation
   * Lower extremity endarterectomy (including femoral and iliac vessels) Of note, this list of procedures is not exhaustive and other procedures may be considered that meet inclusion criteria and no exclusion criteria, in consultation with the treatment teams involved.

Exclusion Criteria:

1. Patient is pregnant
2. Patient is a prisoner
3. Patient is \< 18 years old
4. The treating clinicians determine that the patient's clinical condition necessitate a specific approach to surgical scheduling or preoperative hemodialysis

Where it's running

• Stanford University
  Stanford, California, United States Recruiting

Study contacts

• Principal investigator: Vikram Fielding-Singh, MD, JD — Stanford University

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.