Pediatric KIDney Stone (PKIDS) Care Improvement Network (PKIDS)
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|ClinicalTrials.gov Identifier: NCT04285658|
Recruitment Status : Recruiting
First Posted : February 26, 2020
Last Update Posted : April 3, 2020
|Condition or disease||Intervention/treatment|
|Kidney Stone Nephrolithiasis||Procedure: Ureteroscopy Procedure: Percutaneous Nephrolithotomy Procedure: Shock Wave Lithotripsy|
The rapid increase in the incidence of kidney stones among youth has resulted in a large population of patients who require surgery to removes stones but for whom little evidence exists to guide clinical care. Proper selection of surgical treatment options, which is directed by patient-specific factors and individual treatment goals, is the greatest determinant of successful outcomes.
This is a prospective cohort study. Investigators seek to compare stone clearance, re-treatment, and unplanned healthcare encounters for ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy.
Additionally, Investigators also seek to compare patients' experiences after ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy.
This study will be conducted by the Pediatric KIDney Stone (PKIDS) Care Improvement Network, which includes 20 pediatric healthcare systems (22 sites) in the United States.
Patient participants include patients aged 8 to 21 years who undergo a surgical intervention for kidney stones as part of their clinical care. The surgical interventions include ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy, all of which would be performed as part of routine clinical care.
Study Interventions and Measures:
Stone clearance will be assessed with ultrasound (obtained as part of clinical care) 6 weeks after surgery, which is the standard of care at all PKIDS sites. Re-treatment and unplanned healthcare encounters will be assessed within the first 3 months after surgery. Patients' experiences will be measured through questionnaires administered pre-operatively and within 3 months after surgery.
|Study Type :||Observational|
|Estimated Enrollment :||1290 participants|
|Official Title:||Pediatric KIDney Stone (PKIDS) Care Improvement Network|
|Actual Study Start Date :||April 2, 2020|
|Estimated Primary Completion Date :||October 2022|
|Estimated Study Completion Date :||January 2024|
An outpatient endoscopic surgery that accesses the ureters and kidneys per the urethra to fragment and remove the stones. Many patients who undergo ureteroscopy (URS), Shockwave lithotripsy (SWL), or percutaneous nephrolithotomy (PCNL) also have temporary tubes placed after the surgery to facilitate drainage, either internally (a stent) or externally (a nephrostomy tube).
Other Name: URS
Procedure: Percutaneous Nephrolithotomy
A minimally invasive surgery in which a ~1cm flank incision is made, and a scope is passed through a tubular sheath into the kidney to fragment and remove the stone. There is typically a 1- to 2-day hospital stay. Many patients who undergo URS, SWL, or PCNL also have temporary tubes placed after the surgery to facilitate drainage, either internally (a stent) or externally (a nephrostomy tube).
Other Name: PCNL
|Shock Wave Lithotripsy||
Procedure: Shock Wave Lithotripsy
A non-invasive outpatient procedure that targets stones in the kidney or ureter with x-ray or ultrasound and uses shockwaves generated outside the body to fragment them; the fragments pass down the ureter and the patient expels them in the urine. Many patients who undergo URS, SWL, or PCNL also have temporary tubes placed after the surgery to facilitate drainage, either internally (a stent) or externally (a nephrostomy tube).
Other Name: SWL
- Stone clearance [ Time Frame: 6 weeks post-op +/- 2 weeks ]Presence or absence of kidney stones will be assessed via post-operative clinically-indicated renal bladder ultrasound.
- Patient-Reported Outcomes [ Time Frame: Immediate impact (within 7 days) and delayed impact (up to 90 days) after surgery ]Patients' experiences before and after URS, SWL, and PCNL will be measured. Investigators will assess the immediate and delayed impact of surgery on patient-reported outcomes (PROs) selected by PKIDS patient partners. The patient reported outcomes (PROs) include the Patient-Reported Outcomes Measurement Information System (PROMIS), other questionnaires commonly used in studying the impact of kidney stone disease on health states, and urinary tract symptoms.
- Patients' Experiences [ Time Frame: Immediate impact (within 7 days) and delayed impact (up to 90 days) after surgery ]Investigators will examine Heterogeneity of Treatment Effect (HTE) by age and sex and identify modifiable surgical techniques that impact patient experiences for each surgery.
- Patients' Experiences [ Time Frame: Up to 90 days after surgery ]Investigators will also determine unplanned hospitalizations, emergency department (ED) visits, and repeat surgeries for the 3 months following each procedure to examine impact on patients' experiences.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04285658
|Contact: Director of PKIDS Operationsfirstname.lastname@example.org|