Wednesday, 19 May 2021
A new study will look at the effectiveness of using a unique silicone catheter with built-in antibiotics in preventing infection in patients using dialysis for kidney disease at home.
The CAP study (Clinical Evaluation, Development and Commercialisation of an Antimicrobial – Impregnated Catheter Against Peritonitis) is receiving funding from the NIHR Invention for Innovation Programme, and is being led by Professors Maarten Taal and Roger Bayston, with a team of experts at the University of Nottingham and University Hospitals of Derby and Burton NHS Foundation Trust.
Peritoneal dialysis (PD) is a type of dialysis that is used to treat people with kidney failure at home. A silicone tube is placed with one end in the abdomen and the other exiting through the skin. Fluid is run into the abdomen through the tube, and then drained out again after 1-4 hours. The process is repeated multiple times every day.
While the fluid is in the abdomen, toxins and other waste chemicals move from the body into the fluid and are removed when the fluid is drained out. In this way, PD partially replaces kidney function.
However, infection related to the tube is the most common risk associated with PD. This may be mild if it affects only the skin, but can be severe if the infection spreads to the abdomen. This is called peritonitis, which may cause severe pain and even life-threatening sepsis.
Currently, the only measures available to prevent PD tube infections are careful hygiene when handling the tube and antibiotics. Despite these measures, peritonitis is one of the most common causes of people having to stop PD and change to another form of dialysis that involves direct filtration of the blood (haemodialysis).
In this study the team will test a PD tube that has had three different antibiotics built into the silicone using a special patented process developed by the University of Nottingham group.
The team will study 40 people needing PD who will have the antibiotic-treated tubes placed as part of their normal care. They will look at whether the tubes are safe to use and, importantly, are acceptable to patients. They will also check whether the tubes are associated with any increase in bacteria that are resistant to antibiotics.
Peritonitis accounts for 20% of PD patient deaths, and the only available measure to prevent it is careful hygiene when handling the tube. PD is such an important treatment for people with kidney disease, as it can be done in their own homes, so we need to find a way of reducing the infection risk."
Niall Buntain, 58, from Burton on Trent, has been using PD for two years. He said: “When you first start using PD, the renal team cannot stress enough the importance of being clean and hygienic, and when you first start to go through the process it can be overwhelming. It’s a fairly robotic process and you have to keep focus. A lot of people who start on this type of dialysis find it takes time to get into the habit and in the early days you’re far more likely to pick up an infection, simply because you’re not used to it. As much as you try to be careful, it can be hard to adjust to the routine. This new type of catheter will really help and will take a lot of the risk away.”
Story credits
More information is available from Dr Katie Belfield, a Research Fellow from the School of Medicine at the University of Nottingham at Katherine.belfield@nottingham.ac.uk
About the National Institute for Health Research
The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:
- Funds, supports and delivers high quality research that benefits the NHS, public health and social care
- Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- Partners with other public funders, charities and industry to maximise the value of research to patients and the economy
The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.
This study is funded by the National Institute for Health Research (NIHR) Invention for Innovation (i4i) Programme. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Notes to editors:
About the University of Nottingham
Ranked 32 in Europe and 16th in the UK by the QS World University Rankings: Europe 2024, the University of Nottingham is a founding member of the Russell Group of research-intensive universities. Studying at the University of Nottingham is a life-changing experience, and we pride ourselves on unlocking the potential of our students. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement.
Nottingham was crowned Sports University of the Year by The Times and Sunday Times Good University Guide 2024 – the third time it has been given the honour since 2018 – and by the Daily Mail University Guide 2024.
The university is among the best universities in the UK for the strength of our research, positioned seventh for research power in the UK according to REF 2021. The birthplace of discoveries such as MRI and ibuprofen, our innovations transform lives and tackle global problems such as sustainable food supplies, ending modern slavery, developing greener transport, and reducing reliance on fossil fuels.
The university is a major employer and industry partner - locally and globally - and our graduates are the second most targeted by the UK's top employers, according to The Graduate Market in 2022 report by High Fliers Research.
We lead the Universities for Nottingham initiative, in partnership with Nottingham Trent University, a pioneering collaboration between the city’s two world-class institutions to improve levels of prosperity, opportunity, sustainability, health and wellbeing for residents in the city and region we are proud to call home.
More news…