Dialysis; Complications Clinical Trial
Official title:
Pilot Study to Determine Whether Cooled Peritoneal Dialysis Fluid Confers Cardio-Protective Effects
The study team aimed to investigate the relationship between occlusive coronary artery
disease, myocardial perfusion, and peritoneal dialysate temperature. In addition, the study
team aimed to identify how abnormal myocardial perfusion in peritoneal dialysis (PD) patients
is related to occlusive coronary artery disease, to identify factors associated with
occlusive coronary artery disease in end-stage renal failure patients on PD. Finally, the
study team identified factors associated with PD induced cardiac injury in end-stage renal
failure patients on this dialysis modality.
In order to assess the patients response to physiological stress and the functional relevance
of their coronary artery disease, patients underwent assessment using dual energy contrast
enhanced (DCE) CT assessment of coronary arteries and myocardial perfusion. An initial CT
scan with administration of contrast established baseline information regarding the extent of
coronary artery disease, fibrosis, and myocardial perfusion at rest. Following this, patients
underwent pharmacological stress with the administration of adenosine and a repeat CT scan
established the response to stress in terms of myocardial perfusion. On the second study
visit patients were started on C-CAPD using peritoneal dialysate cooled to between 32-33
degrees centigrade, at a pre-determined and precisely controlled temperature for the 4 hour
duration of C-CAPD. Subsequently, patients were injected with a pharmacological stressor in
the form of adenosine. They then underwent DCE CT assessment of coronary arteries and
myocardial perfusion as done in the first visit. The second CT scan took place following a PD
dwell.
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