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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04122222
Other study ID # 07-59-14
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date August 25, 2016
Est. completion date July 20, 2018

Study information

Verified date October 2019
Source Mahidol University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

On-line hemodiafiltration (HDF) clears more azotaemic toxins compared to high-flux hemodialysis (HD). The response to vaccination is impaired in dialysis patients. We aimed to study the immune responses to influenza vaccine in dialysis patients treated by HDF vs. HD.


Recruitment information / eligibility

Status Completed
Enrollment 60
Est. completion date July 20, 2018
Est. primary completion date July 20, 2018
Accepts healthy volunteers No
Gender All
Age group N/A and older
Eligibility Inclusion Criteria:

- ESRD patients aged 18 years or older, who had been treated for more than one month of either thrice weekly on-line hemodiafiltration (HDF) or conventional high flux hemodialysis (HD), with a session dialyzer urea clearance (Kt/V urea) of 1.2 and greater, with a convection volume target of 20 L/session for the HDF group

Exclusion Criteria:

- Had received any vaccination within the previous four weeks, or influenza vaccination within six months

- Patient who reported upper respiratory tract symptoms within three days prior to the study vaccination

- A history of allergy to influenza vaccine or egg

- Thrombocytopenia

- In receipt of immunosuppressant medications, chemotherapy, or had immunodeficiency

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
Influenza vaccine
A single standard dose of inactivated trivalent influenza vaccine: Influvac® vaccines (Abbott, the Netherlands), intramuscularly.

Locations

Country Name City State
n/a

Sponsors (3)

Lead Sponsor Collaborator
Mahidol University Bhumirajanagarindra Kidney Institute, Thailand, Ministry of Health, Thailand

References & Publications (33)

Allon M, Depner TA, Radeva M, Bailey J, Beddhu S, Butterly D, Coyne DW, Gassman JJ, Kaufman AM, Kaysen GA, Lewis JA, Schwab SJ; HEMO Study Group. Impact of dialysis dose and membrane on infection-related hospitalization and death: results of the HEMO Stud — View Citation

Anding K, Gross P, Rost JM, Allgaier D, Jacobs E. The influence of uraemia and haemodialysis on neutrophil phagocytosis and antimicrobial killing. Nephrol Dial Transplant. 2003 Oct;18(10):2067-73. — View Citation

Ausiello CM, la Sala A, Ramoni C, Urbani F, Funaro A, Malavasi F. Secretion of IFN-gamma, IL-6, granulocyte-macrophage colony-stimulating factor and IL-10 cytokines after activation of human purified T lymphocytes upon CD38 ligation. Cell Immunol. 1996 No — View Citation

Betjes MG, Langerak AW, van der Spek A, de Wit EA, Litjens NH. Premature aging of circulating T cells in patients with end-stage renal disease. Kidney Int. 2011 Jul;80(2):208-17. doi: 10.1038/ki.2011.110. Epub 2011 Apr 27. — View Citation

Carracedo J, Merino A, Nogueras S, Carretero D, Berdud I, Ramírez R, Tetta C, Rodríguez M, Martín-Malo A, Aljama P. On-line hemodiafiltration reduces the proinflammatory CD14+CD16+ monocyte-derived dendritic cells: A prospective, crossover study. J Am Soc — View Citation

Chou CY, Wang SM, Liang CC, Chang CT, Liu JH, Wang IK, Hsiao LC, Muo CH, Huang CC, Wang RY. Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study. Medicine (Baltimore). 2014 — View Citation

Co MD, Orphin L, Cruz J, Pazoles P, Rothman AL, Ennis FA, Terajima M. Discordance between antibody and T cell responses in recipients of trivalent inactivated influenza vaccine. Vaccine. 2008 Apr 7;26(16):1990-8. doi: 10.1016/j.vaccine.2008.02.024. Epub 2 — View Citation

Cohen G, Hörl WH. Immune dysfunction in uremia—an update. Toxins (Basel). 2012 Oct 24;4(11):962-90. doi: 10.3390/toxins4110962. Review. — View Citation

Collins AJ, Foley RN, Gilbertson DT, Chen SC. The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis. Clin J Am Soc Nephrol. 2009 Dec;4 Suppl 1:S5-11. doi: 10.2215/CJN.05980809. Review. — View Citation

Crespo M, Collado S, Mir M, Cao H, Barbosa F, Serra C, Hidalgo C, Faura A, Montero M, García de Lomas J, Horcajada JP, Puig JM, Pascual J. Efficacy of influenza A H1N1/2009 vaccine in hemodialysis and kidney transplant patients. Clin J Am Soc Nephrol. 201 — View Citation

DaRoza G, Loewen A, Djurdjev O, Love J, Kempston C, Burnett S, Kiaii M, Taylor PA, Levin A. Stage of chronic kidney disease predicts seroconversion after hepatitis B immunization: earlier is better. Am J Kidney Dis. 2003 Dec;42(6):1184-92. — View Citation

Dede F, Yildiz A, Ayli D, Colak N, Odabas AR, Akoglu H, Eskioglu E, Covic A. Modulation of the immune response to HBV vaccination by hemodialysis membranes. Int Urol Nephrol. 2010 Dec;42(4):1069-75. doi: 10.1007/s11255-009-9616-z. Epub 2009 Jul 19. — View Citation

den Hoedt CH, Bots ML, Grooteman MP, van der Weerd NC, Mazairac AH, Penne EL, Levesque R, ter Wee PM, Nubé MJ, Blankestijn PJ, van den Dorpel MA; CONTRAST Investigators. Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialy — View Citation

den Hoedt CH, Grooteman MP, Bots ML, Blankestijn PJ, van der Tweel I, van der Weerd NC, Penne EL, Mazairac AH, Levesque R, ter Wee PM, Nubé MJ, van den Dorpel MA; CONTRAST investigators. The Effect of Online Hemodiafiltration on Infections: Results from t — View Citation

Descamps-Latscha B. The immune system in end-stage renal disease. Curr Opin Nephrol Hypertens. 1993 Nov;2(6):883-91. Review. — View Citation

Ducloux D, Legendre M, Bamoulid J, Rebibou JM, Saas P, Courivaud C, Crepin T. ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications. Immun Ageing. 2018 Jul 17;15:16. doi: 10.1186/s12979-018-0121-z. eCollectio — View Citation

Eiselt J, Kielberger L, Rajdl D, Racek J, Pazdiora P, Malánová L. Previous Vaccination and Age are More Important Predictors of Immune Response to Influenza Vaccine than Inflammation and Iron Status in Dialysis Patients. Kidney Blood Press Res. 2016;41(2) — View Citation

Fernández-Fresnedo G, Ramos MA, González-Pardo MC, de Francisco AL, López-Hoyos M, Arias M. B lymphopenia in uremia is related to an accelerated in vitro apoptosis and dysregulation of Bcl-2. Nephrol Dial Transplant. 2000 Apr;15(4):502-10. — View Citation

Girndt M, Sester M, Sester U, Kaul H, Köhler H. Molecular aspects of T- and B-cell function in uremia. Kidney Int Suppl. 2001 Feb;78:S206-11. Review. — View Citation

Hauser AB, Stinghen AE, Kato S, Bucharles S, Aita C, Yuzawa Y, Pecoits-Filho R. Characteristics and causes of immune dysfunction related to uremia and dialysis. Perit Dial Int. 2008 Jun;28 Suppl 3:S183-7. Review. — View Citation

Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, Tranaeus A, Stenvinkel P, Lindholm B. Aspects of immune dysfunction in end-stage renal disease. Clin J Am Soc Nephrol. 2008 Sep;3(5):1526-33. doi: 10.2215/CJN.00950208. Epub 2008 Aug 13. — View Citation

Lim WH, Kireta S, Leedham E, Russ GR, Coates PT. Uremia impairs monocyte and monocyte-derived dendritic cell function in hemodialysis patients. Kidney Int. 2007 Nov;72(9):1138-48. Epub 2007 Aug 29. — View Citation

Meijers RW, Litjens NH, de Wit EA, Langerak AW, van der Spek A, Baan CC, Weimar W, Betjes MG. Uremia causes premature ageing of the T cell compartment in end-stage renal disease patients. Immun Ageing. 2012 Sep 12;9(1):19. doi: 10.1186/1742-4933-9-19. — View Citation

Moro-García MA, Alonso-Arias R, López-Larrea C. When Aging Reaches CD4+ T-Cells: Phenotypic and Functional Changes. Front Immunol. 2013 May 10;4:107. doi: 10.3389/fimmu.2013.00107. eCollection 2013. — View Citation

Nordio M, Limido A, Maggiore U, Nichelatti M, Postorino M, Quintaliani G; Italian Dialysis and Transplantation Registry. Survival in patients treated by long-term dialysis compared with the general population. Am J Kidney Dis. 2012 Jun;59(6):819-28. doi: — View Citation

Rama I, Llaudó I, Fontova P, Cerezo G, Soto C, Javierre C, Hueso M, Montero N, Martínez-Castelao A, Torras J, Grinyó JM, Cruzado JM, Lloberas N. Online Haemodiafiltration Improves Inflammatory State in Dialysis Patients: A Longitudinal Study. PLoS One. 20 — View Citation

Sarnak MJ, Jaber BL. Pulmonary infectious mortality among patients with end-stage renal disease. Chest. 2001 Dec;120(6):1883-7. — View Citation

Sester U, Sester M, Hauk M, Kaul H, Köhler H, Girndt M. T-cell activation follows Th1 rather than Th2 pattern in haemodialysis patients. Nephrol Dial Transplant. 2000 Aug;15(8):1217-23. — View Citation

Valkenburg SA, Li OTW, Li A, Bull M, Waldmann TA, Perera LP, Peiris M, Poon LLM. Protection by universal influenza vaccine is mediated by memory CD4 T cells. Vaccine. 2018 Jul 5;36(29):4198-4206. doi: 10.1016/j.vaccine.2018.06.007. Epub 2018 Jun 7. — View Citation

Viasus D, Garcia-Vidal C, Cruzado JM, Adamuz J, Verdaguer R, Manresa F, Dorca J, Gudiol F, Carratalà J. Epidemiology, clinical features and outcomes of pneumonia in patients with chronic kidney disease. Nephrol Dial Transplant. 2011 Sep;26(9):2899-906. do — View Citation

Xiaoyan J, Rongyi C, Xuesen C, Jianzhou Z, Jun J, Xiaoqiang D, Xiaofang Y. The difference of T cell phenotypes in end stage renal disease patients under different dialysis modality. BMC Nephrol. 2019 Aug 5;20(1):301. doi: 10.1186/s12882-019-1475-y. — View Citation

Young B, Zhao X, Cook AR, Parry CM, Wilder-Smith A, I-Cheng MC. Do antibody responses to the influenza vaccine persist year-round in the elderly? A systematic review and meta-analysis. Vaccine. 2017 Jan 5;35(2):212-221. doi: 10.1016/j.vaccine.2016.11.013. — View Citation

Zupo S, Rugari E, Dono M, Taborelli G, Malavasi F, Ferrarini M. CD38 signaling by agonistic monoclonal antibody prevents apoptosis of human germinal center B cells. Eur J Immunol. 1994 May;24(5):1218-22. — View Citation

* Note: There are 33 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary measurement antibody titers, determined by hemagglutination inhibition (HI) assay. measurement antibody titers, determined by hemagglutination inhibition (HI) assay. 12 months
Secondary measurement T cell subpopulations, determined by flow cytometer AND cell proliferation assay after stimulated with influenza viruses. measurement T cell subpopulations, determined by flow cytometer AND cell proliferation assay after stimulated with influenza viruses. 12 months
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