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Trial registered on ANZCTR
Registration number
ACTRN12612000916842
Ethics application status
Not yet submitted
Date submitted
24/08/2012
Date registered
28/08/2012
Date last updated
28/08/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Examining the use of intravenous nutrition support during dialysis to improve the appetite of dialysis patients who are suffering from malnutrition
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Scientific title
Intradialytic parental nutrition and appetite in malnourished haemodialysis patients: Does ClinOleic 20% have an appetite stimulating effect?
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Secondary ID [1]
281087
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Haemodialysis in patients with kidney failure
287240
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Malnutrition in patients with kidney failure
287241
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Condition category
Condition code
Diet and Nutrition
287565
287565
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0
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Other diet and nutrition disorders
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Renal and Urogenital
287566
287566
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
500mls ClinOleic 20% Intradialytic Parental Nutrition will be administered whilst each subject is undergoing routine thrice-weekly haemodialysis. The IDPN bag will be connected by a tube to the venous chamber of the dialysis machine and the IDPN solution will be infused over the 4 hour dialysis session. Patients will receive the IDPN infusion during each dialysis session (three times a week) for 12 weeks. Blood pressure, blood glucose and tryglceride levels will be monitored during the period of the intervention.
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Intervention code [1]
285539
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Treatment: Other
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Comparator / control treatment
Standard care- dietary advice and oral nutritional supplements prescribed by dietitian (one on one) to meet energy and protein requirements
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Control group
Active
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Outcomes
Primary outcome [1]
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The patients serum albumin level will be recorded when the monthly blood tests are taken (all haemodialysis patients ordinarilly have a monthly blood test which measures serum albumin level)
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Assessment method [1]
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Timepoint [1]
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0, 1, 2, 3 and 6 months
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Secondary outcome [1]
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Appetite measured by the Visual analogue scale
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Assessment method [1]
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Timepoint [1]
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0, 1, 2, 3 and 6 months
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Secondary outcome [2]
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Fasting blood samples will be taken to measure changes in appetite hormones such as acyl-ghrelin, leptin, gastric inhibitory peptide (GIP), glucagon-like peptide-1 (GLP-1), cholecystokinin (CCK), peptide YY (pYY), neuropeptide Y (NPY), adiponectin, and insulin-like growth factor-1 (IGF-1). Blood samples will be centrigfuged to obtain plasma which will be stored at -80C for batch analysis. Acyl-ghrelin, GLP-1, CCK, pYY and IGF-1 will be analysed at established laboratories in Adelaide. ELISA kits will be used for NPY, leptin and adiponectin.
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Assessment method [2]
298881
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Timepoint [2]
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0, 3 months
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Secondary outcome [3]
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Fasting blood samples will be taken to measure changes in inflammatory cytokines such as interleukin (IL) -2, IL-6,and tumor necrosis factor alpha (TNF-a). Blood samples will be centrigfuged to obtain plasma which will be stored at -80C for batch analysis. Cytokine kits (ELISA) will be used for the analysis.
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Assessment method [3]
298882
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Timepoint [3]
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0, 3 months
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Secondary outcome [4]
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DEXA scans of lean body and fat mass
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Assessment method [4]
298883
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Timepoint [4]
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0, 3, 6 months
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Secondary outcome [5]
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Quality of life KD-QOL Survey
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Assessment method [5]
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Timepoint [5]
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0, 3, 6 months
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Secondary outcome [6]
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Normalised protein nitrogen appearance will be calculated from midweek dialysis serum urea levels. The patients will have this blood test as part of their routine monthly blood tests (normally blood is taken prior to and after a mid week dialysis session).
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Assessment method [6]
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Timepoint [6]
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0, 1, 2, 3, 6 months
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Secondary outcome [7]
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Weight measured in kilograms
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Assessment method [7]
298886
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Timepoint [7]
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0, 1, 2, 3, 6 months
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Secondary outcome [8]
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Patient-generated subjective global assessment will be undertaken by a dietitian (dietitian assessment tool for malnutrition)
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Assessment method [8]
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Timepoint [8]
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0, 3, 6 months
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Secondary outcome [9]
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Hospitalisations will be recorded from the medical notes, inclueding the number of admissions and number of days in hospital
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Assessment method [9]
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Timepoint [9]
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6 months
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Eligibility
Key inclusion criteria
Undergoing maintenance haemodialysis AND
BMI 19.8-22.9 plus serum albumin 25>35g/L or body weight loss 5-10% past 6 months
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Not undergoing maintenance haemodialysis, BMI< 19.8 or > 22.9, serum albumin >35g/L with < 5% body weight loss in the past 6 months, serum albumin <25g/L with body weight loss >10% in the past 6 months, egg or soy allergy, uncontrolled or untreated diabetes mellitus, Type I diabetes, diagnosis of malignancy, active infection, uncontrolled cardiac failure, liver failure, pancreatic insufficiency or other non-renal reason for malnutrition
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be screened to check they meet the inclusion criteria and then enrolled in study. Patients will be assigned a study number (sequentially) and allocated treatment according to the randomisation sequence generated.
The randomisation sequence will be concealed and the allocation of treatment will only be revealed once the study number has been allocated to the patient. In order to obtain the treatment allocation the study dietitian will contact the holder of the allocation schedule (off-site) via interstate phone call.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation sequence will be generated using www.randomisation.com
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Investigators undertaking data input and analysis will be blinded to treatement allocation
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/01/2013
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
285872
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Country [1]
285872
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Australia
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Primary sponsor type
Hospital
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Name
Central Northern Adelaide Renal and Transplant Unit
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Address
Level 9, East Wing, Royal Adelaide Hospital
North Terrace
Adelaide SA 5000
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Country
Australia
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Secondary sponsor category [1]
284697
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University
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Name [1]
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University of South Australia
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Address [1]
284697
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Frome St
Adelaide SA 5000
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Country [1]
284697
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Anthony Meade
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Address [1]
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Central Northern Adelaide Renal and Transpant Unit
Level 9, East Wing, Royal Adelaide Hospital
North Terrace
Adelaide SA 5000
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Country [1]
277034
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Australia
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Other collaborator category [2]
277035
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Individual
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Name [2]
277035
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Dr Shilpa Jesudason
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Address [2]
277035
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Central Northern Adelaide Renal and Transpant Unit
Level 9, East Wing, Royal Adelaide Hospital
North Terrace
Adelaide SA 5000
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Country [2]
277035
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Australia
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Other collaborator category [3]
277036
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Individual
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Name [3]
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Dr David Jesudason
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Address [3]
277036
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Endocrine Unit, Queen Elizabeth Hospital,
28 Woodville Road, Woodville West SA 5011
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Country [3]
277036
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Australia
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Other collaborator category [4]
277037
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Individual
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Name [4]
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Dr Juan Jesus Carrero
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Address [4]
277037
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Division Renal Medicine,
Karolinksa Institutet,
Solnavagen 1, Solna,
Alfred Nobels Alle 8, Huddinge,
Stockholm
Sweden
Postal address:
SE-171 77 Stockholm Sweden
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Country [4]
277037
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Sweden
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
287901
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Royal Adelaide Hospital Ethics Committee
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Ethics committee address [1]
287901
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IMVS building, Royal Adelaide Hospital North Terrace Adelaide SA 5000
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Ethics committee country [1]
287901
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Australia
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Date submitted for ethics approval [1]
287901
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29/08/2012
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Approval date [1]
287901
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Ethics approval number [1]
287901
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Summary
Brief summary
Malnutrition is a critical issue affecting the quality of life of patients with end-stage kidney failure on dialysis, and is associated with chronic inflammation, adverse patient outcomes and increased death. Nutritional support is highly important in this patient group, but often oral supplements are insufficient to correct the malnourished state. Intradialytic parenteral nutrition (IDPN) is intravenous nutrition supplementation which is given during dialysis treatments. IDPN has had some promising effects on appetite, food intake, body weight and other markers of nutritional health, but needs to be studied more closely particularly before patients develop severe malnutrition. This multidisciplinary, collaborative project aims to compare IDPN versus standard dietetic input (control group) in malnourished dialysis patients, and look at the effect on a comprehensive range of key markers of nutrition and patient quality of life. We aim to address this important clinical problem, to obtain evidence for new therapeutic approaches to improve patient outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
34614
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Address
34614
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Country
34614
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Phone
34614
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Fax
34614
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Email
34614
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Contact person for public queries
Name
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Anthony Meade
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Address
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C/- level 6 Renal Consulting Area, Emergency Block, Royal Adelaide Hospital, North Tce, Adelaide, SA 5000
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Country
17861
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Australia
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Phone
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+61 8 8222 0984
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Fax
17861
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+61 8 8222 5135
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Email
17861
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[email protected]
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Contact person for scientific queries
Name
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Alwyn Todd
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Address
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University of South Australia
Frome St
Adelaide SA 5000
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Country
8789
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Australia
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Phone
8789
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+61 8 8302 9937
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Fax
8789
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Email
8789
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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