A Study of Cytokine and Inflammatory Markers in Patients With Chronic Renal Failure
Condition: Chronic Renal Failure
MeSH terms: Renal Insufficiency; Kidney Failure, Chronic; Renal Insufficiency, Chronic
Study type: Observational

Summary: 
      We hope to study components within the blood that may predict success, failure or other
      associated complications in relation to the type of vascular access being used.
    

Detailed description: 
      Renal failure affects more than 350,000 patients in the United States. All patients
      undergoing dialysis must have access to the vascular system (blood stream) for hemodialysis
      treatment. Methods of access include a catheter, or tube, that goes through the skin and into
      a large vein, a surgically created connection of a vein to an artery called an AV fistula, or
      a surgically created connection of a vein to artery using a graft or plastic tube. Previous
      research has shown considerable differences in the function and success in these types of
      vascular access for dialysis. Research investigators try to explain these differences and
      find the causes and explanations for the variations seen in vascular access.

      Forty patients undergoing dialysis treatment will be evaluated by analyzing serum specimens
      obtained during outpatient hemodialysis access. Serum will also be collected from ten
      pre-dialysis patients and ten normal volunteers for comparison. Pre-dialysis patients are
      those who have Stage 3, 4, or 5 chronic kidney disease but are not yet on dialysis and have
      never had any type of created vascular access. Normal subjects will have no kidney disease,
      autoimmune disorders, recent (<6 months) chemotherapy treatment or corticosteroid use, or
      other chronic condition determined by the investigator to interfere with cytokine and
      inflammatory markers. The serum specimens will be analyzed for cytokine/inflammatory markers
      and correlated with clinical access type and other medical data and demographic information.
    

Intervention name(s): Blood Draw
Intervention type(s): Procedure
Intervention description(s): For patients undergoing routine hemodialysis for chronic renal failure, 5-10 ml of blood will be removed from the dialysis tubing during vascular access. All other subjects will have 5-10 ml of blood drawn by routine venipuncture.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Male and female patients of Dr. William Jennings and Dr. Pranay Kathuria undergoing
        dialysis therapy as outpatients. Dialysis and pre-dialysis patients will be recruited from
        Dr. Pranay Kathuria's practice. Normal volunteers will be recruited from family members of
        the pre-dialysis patients, Internal Medicine patients already scheduled to have blood drawn
        for other reasons, or from faculty/staff/student volunteers who are not otherwise involved
        with the study and are not in a subordinate role to any of the study investigators.
      
Biospecimen description: 
      serum
    
Keywords: hemodialysis; Vascular access; arteriovenous fistula; indwelling percutaneous catheters; arteriovenous grafts