Stratford Upon Avon

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.

Researchers are evaluating a new blood test called Avantect to detect pancreatic cancer early in people aged 50 to 84 who were recently diagnosed with type 2 diabetes. Pancreatic cancer is often deadly because it is usually found late. This study aims to see if the Avantect test can find signs of cancer sooner, allowing for earlier treatment and better chances of survival. The study is interventional and includes a large group of participants recruited from general practices over three years. Participants will be randomly assigned to one of two groups the intervention arm or the control arm. Those in the intervention arm will have their blood samples tested with the Avantect test quickly, and if cancer markers are found, they will be informed and offered imaging scans like MRI or CT to check for pancreatic cancer. The control group will have their blood samples stored for possible future testing but will receive standard diabetes care. Blood samples and health outcomes will be tracked for three years. Each participant will attend three study visits over 12 months, providing blood samples and completing anxiety questionnaires. Researchers will monitor cancer diagnosis and mortality through registries for three years after consent. They will evaluate the tests sensitivity, specificity, and ability to detect cancer early enough for surgery. The study also measures predictive values and cancer resectability. This design helps understand the tests potential to improve pancreatic cancer detection in people with new diabetes diagnoses.