Kingston

Researchers are evaluating the impact of two different default dialysate sodium concentrations on major cardiovascular events and death in adults receiving maintenance haemodialysis for end-stage kidney disease. This pragmatic, cluster-randomised, open-label Phase 4 study compares sodium levels of 137 mmoll and 140 mmoll in real-world dialysis settings across multiple sites globally. Dialysis sites will be randomly assigned to use either a default dialysate sodium concentration of 137 mmoll or 140 mmoll for at least 90% of dialysis sessions. Other aspects of patient care will follow standard local practices. Sites must consent to participate, and individual patients will provide waiver or opt-out consent. The study expects to enroll sites over 5 to 7 years, with each participant followed for approximately 2 to 5 years until the study endpoints are reached. Participants will receive dialysis at their assigned sites with the designated sodium concentration. Researchers will monitor the time to first occurrence of major cardiovascular events or death as the primary outcome. Secondary outcomes include other cardiovascular events and individual components of the composite outcomes. Data collection and patient monitoring will continue throughout the study period, estimated to last around five years per participant.

Rapid Diagnostic Centres RDCs are designed to quickly diagnose patients who show common symptoms that might be related to cancer, such as weight loss, fatigue, cough, or a general practitioners suspicion. This observational study aims to develop new blood or non-blood tests that help doctors identify which patients have cancer and which are at higher risk, so they can be monitored or directed to appropriate screening programs. The study focuses on improving diagnosis and risk assessment in patients referred to RDCs, many of whom may not have cancer but could be at risk due to inherited or environmental factors. The study collects breath, blood, and saliva samples from up to 1000 patients attending RDCs to develop tests that can detect cancer or assess cancer risk through polygenic risk scores. Samples are taken at the first appointment and follow-up visits if necessary. Patients provide consent and are assigned a unique Study ID to keep their information confidential. Clinical data, patient health questionnaires, and, for some, anonymized scans from medical records are also collected to support the development of diagnostic tools. Participants will provide samples and complete health surveys at their visits, with samples shipped to labs for analysis. The study will follow patients for 12 months after joining to confirm diagnoses and observe outcomes. Researchers will analyze clinical, genetic, imaging, and symptom data to develop models that distinguish between cancer and non-cancer cases. Patient data and samples will be stored for ten years to support future research and improved diagnostic methods.