Stratford Upon Avon

Researchers are evaluating the effects of two different default dialysate sodium concentrations, 137 mmol/l and 140 mmol/l, on major cardiovascular events and death in adults receiving maintenance haemodialysis. This pragmatic, cluster-randomised, open-label study takes place in real-world dialysis sites and aims to compare the outcomes associated with these sodium levels over an extended period. The study focuses on patients with end-stage kidney disease undergoing regular haemodialysis treatment. Dialysis sites are randomly assigned to use either a default dialysate sodium concentration of 137 mmol/l or 140 mmol/l for at least 90% of dialysis sessions at that site. All other care practices continue as usual based on local standards. The study plans to recruit sites over 5 to 7 years, with individual follow-up lasting roughly 2 to 5 years. Site participation requires consent, while individual patient consent may be waived or offered an opt-out option. Participants will be monitored for major cardiovascular events and death, with the primary outcome measuring the time until the first such event occurs. Data collection methods are implemented across participating dialysis units, focusing only on in-center or satellite dialysis patients where applicable. The study's duration depends on the occurrence of endpoints, with an average follow-up of about 5 years anticipated per participant.

Researchers are investigating the Avantect test, a new blood test designed to detect pancreatic cancer early in patients recently diagnosed with type 2 diabetes. Pancreatic cancer is highly lethal, often detected too late for curative treatment. The study focuses on adults aged 50 to 84 years who were diagnosed with type 2 diabetes within the past six months, as this group has a significantly higher risk of undiagnosed pancreatic cancer. The trial aims to evaluate if the Avantect test can identify pancreatic cancer at a treatable stage, potentially improving survival rates. Participants will be randomly assigned to either an intervention group or a control group. Those in the intervention arm will have their blood samples tested with the Avantect device soon after collection. If the test detects biomarkers suggesting pancreatic cancer, participants will be informed and offered imaging scans such as MRI or CT to confirm diagnosis. Control group samples will be stored for future testing or research. The study will enroll up to 15,000 participants over three years. Each participant will attend three study visits over a 12-month period, providing blood samples and completing anxiety questionnaires at every visit. Researchers will follow all participants remotely via cancer and mortality registries for three years after enrollment to track any cancer diagnoses. The main outcomes measured include the sensitivity and specificity of the Avantect test and the rate at which pancreatic cancer can be surgically removed, with analyses planned at six months and at three years.