P/paraDIGM a Paired pre/post-Dialysis Investigation of Global Metabolomics
P/paraDIGM
What is the goal of the study?
Children with kidney failure (chronic kidney disease stage 5 requiring dialysis [CKD5D] or acute kidney failure) are at high risk for multisystem complications with considerable associated morbidity and mortality.1-5 A key goal of dialysis is clearing accumulated toxins and thereby reducing the risk of clinical complications. There is limited data on how different dialysis modalities remove (or not remove) a large number of circulating toxins. Ensuring adequate toxin clearance, and further identifying ways to optimize clearance, would have important impact on multisystem outcomes in this high-risk population. A key emerging area of interest is how the gut microbiome is altered in CKD5D and how these gut microbiome alterations generate toxins that enter into and accumulate in circulation.6-9 As part of this study, we will be collecting and banking stool samples. This will enable future analyses of a the gut microbiome as an important source of circulating toxins in kidney failure. Objectives: AIM 1: In children receiving chronic hemodialysis (HD), we will quantify pre/post-HD metabolite reduction ratios (RR) and compare them with standard of care dialysis adequacy metrics. AIM 2: In children receiving chronic peritoneal dialysis (PD), we will quantify random plasma and peritoneal effluent metabolite levels and compare them with standard of care dialysis adequacy metrics. Study Design: Observational cohort study
Who can participate in the study?
Please contact the study team listed below to learn more.