Cultivating Innovative, Pragmatic, Randomized Controlled Registry Trials Embedded in Hemodialysis Care: Conference Proceeding From Gardener's Grove 2023.

IF 1.6 Q3 UROLOGY & NEPHROLOGY
Canadian Journal of Kidney Health and Disease Pub Date : 2025-02-14 eCollection Date: 2025-01-01 DOI:10.1177/20543581251318442
Bryn Tannar, Patricia Olar, Shane Kilburn, Kathleen Brown-Blake, Ahmed A Al-Jaishi, Peter G Blake, Kristin K Clemens, Charles Cook, Laura M Dember, Stephanie N Dixon, Cory E Goldstein, Areef Ishani, Catherine Joyes, Conor Judge, James C Kaufman, Susan Q Mackenzie, Taylor McLinden, Amber O Molnar, Alicia Murdoch, Gihad Nesrallah, Sanjay Pandeya, Claudio Rigatto, Pavel S Roshanov, Melissa Schorr, Samuel A Silver, Rona M Smith, Leanne Stalker, Navdeep Tangri, Monica Taljaard, Karthik K Tennankore, Hans Vorster, Charles Weijer, Myles Wolf, Merrick Zwarenstein, Amit X Garg
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引用次数: 0

Abstract

Purpose of the conference: Hemodialysis is a life-sustaining treatment for patients with end-stage kidney disease. However, patients on dialysis continue to face poor quality of life and short life expectancies. Despite this, the nephrology community conducts the fewest randomized controlled trials of any medical discipline, relying instead on expert opinion to guide many aspects of hemodialysis care. There is a need to conduct high-quality pragmatic randomized controlled trials in hemodialysis to drive evidence-based practice. To this end, the Innovative Clinical Trials in Hemodialysis Centers initiative, with the support of the Canadian Institutes of Health Research and its Strategy for Patient-Oriented Research, funded the development of 6 pragmatic trial protocols. Gardener's Grove 2023 created a space to support the development of these trials and increase awareness and knowledge of past, ongoing, and future innovative, pragmatic, randomized controlled registry trials embedded in routine hemodialysis care. This report summarizes the proceedings of this conference.

Sources of information: The conference included 6 panel presentations, each featuring an overview of a new pragmatic trial followed by expert panel feedback from patient partners, nephrologists, researchers, and health care providers. The conference also included 10 educational sessions led by clinicians and researchers with experience in the fields of kidney medicine and clinical trials.

Methods: Gardener's Grove 2023 was a 4-day virtual conference held in March of 2023. Recordings of all the conference presentations were later published on the Gardener's Grove website and are summarized in the Supplemental Appendix of this report.

Key findings: The conference brought together 118 Canadian and international researchers, patients, and health care providers to collaborate on 6 pragmatic trials intended to test interventions to improve hemodialysis care. The proposed trials included (1) PREventing FracturEs in REnal Disease (PREFERRED), (2) DIALysis with EXpanded solute removal (DIALEX), (3) Sodium fOr diaLysis oUTcome rEduction (SOLUTE), (4) Finding the right blood pressure target for patients on dialysis, (5) DIuretic Use in patients with Residual renal function on hemodialysis (DIURESED), and (6) Lower vs higher dialysate bicarbonate concentration in patients receiving hemodialysis (Dial-Bicarb). All of these interventions were widely supported and received valuable feedback from panelists and conference attendees. The education sessions focused on various design and execution elements of pragmatic, randomized controlled registry trials embedded in routine care.

Limitations: The conference could have been improved by streamlining session topics and pacing, allowing additional time for discussions, strengthening online network opportunities, and improving survey response rates. A follow-up conference is planned to take place in a few years, and the coordinators will aim to implement these changes.

Implications: Gardener's Grove 2023 successfully created a space for patients, researchers, and health care providers to support the development of 6 new pragmatic trials in hemodialysis care. Since Gardener's Grove 2023, several of these trials have secured CIHR funding, obtained ethics approval, and are actively preparing to launch their interventions.

在血液透析护理中培养创新、实用、随机对照注册试验:2023年加德纳格罗夫会议纪要。
会议目的:血液透析是终末期肾病患者的一种维持生命的治疗方法。然而,接受透析治疗的患者仍然面临着生活质量差和预期寿命短的问题。尽管如此,肾脏病学界进行的随机对照试验是所有医学学科中最少的,而是依靠专家意见来指导血液透析护理的许多方面。有必要在血液透析中进行高质量的实用随机对照试验,以推动循证实践。为此,在加拿大卫生研究院及其面向患者的研究战略的支持下,血液透析中心创新临床试验倡议资助制定了6项实用试验方案。Gardener's Grove 2023为支持这些试验的发展创造了空间,并提高了对常规血液透析护理中过去、正在进行和未来创新、实用、随机对照注册试验的认识和了解。这份报告概述了这次会议的会议记录。信息来源:会议包括6个小组报告,每个小组报告都概述了一项新的实用试验,然后是来自患者伴侣、肾病学家、研究人员和卫生保健提供者的专家小组反馈。会议还包括由具有肾脏医学和临床试验领域经验的临床医生和研究人员领导的10个教育会议。方法:Gardener's Grove 2023是于2023年3月召开的为期4天的虚拟会议。所有会议演讲的录音后来都发布在园丁园网站上,并在本报告的补充附录中进行了总结。主要发现:会议汇集了118名加拿大和国际研究人员、患者和卫生保健提供者,就6项旨在测试干预措施以改善血液透析护理的实用试验进行合作。拟议的试验包括(1)预防肾脏疾病骨折(PREFERRED),(2)扩展溶质去除透析(DIALEX),(3)降低透析结局的钠(solute),(4)为透析患者找到合适的血压目标,(5)利尿剂在血液透析中残余肾功能患者中的使用(DIURESED),以及(6)血液透析患者中较低和较高的透析液碳酸氢盐浓度(Dial-Bicarb)。所有这些干预措施都得到了小组成员和与会者的广泛支持和宝贵反馈。教育课程侧重于日常护理中实用的随机对照注册试验的各种设计和执行要素。限制:会议可以通过简化会议主题和节奏、允许额外的讨论时间、加强在线网络机会和提高调查回复率来改进。计划在几年内举行一次后续会议,协调员将致力于执行这些变化。启示:Gardener's Grove 2023成功地为患者、研究人员和卫生保健提供者创造了一个空间,以支持在血液透析护理中开展6项新的实用试验。自园丁格罗夫2023年以来,其中一些试验获得了CIHR资助,获得了伦理批准,并正在积极准备启动他们的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
84
审稿时长
12 weeks
期刊介绍: Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.
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