‘TPN CHEK’ (Total Parenteral Nutrition Chloride Home Evaluation Kit)
Research type
Research Study
Full title
TPN-CHEK: Total Parenteral Nutrition-Chloride Home Evaluation Kit study. \nEvaluation of urinary chloride dipsticks for the rapid estimation of hydration status in patients receiving artificial nutrition: Feasibility study \n
IRAS ID
141442
Contact name
Jonathan Tyrrell-Price
Contact email
Sponsor organisation
University Hospitals Bristol NHS Foundation Trust
Duration of Study in the UK
0 years, 5 months, 1 days
Research summary
Patients with intestinal failure (IF) often require artificial feeding that replaces the nutrition and fluids that they are unable to absorb or retain due to bowel dysfunction. These patients are at particular risk of dehydration which is often missed until a patient is seen in hospital or becomes critically unwell. Current guidelines advocate the use of single sample (spot) urinary sodium measurement to guide assessment of hydration status, with a low urinary sodium of < 20 mmol/L suggesting dehydration. However, this requires the use of laboratories with the associated burdens on resources and of patient access, especially as the current framework of care involves fewer accredited centres caring for patients over a wider geographical area. \n\nThis study aims to evaluate the utility and accuracy of a urine chloride dipstick test in estimating urine sodium levels and thus hydration status in patients with IF, having been shown to be an accurate technique in other patient populations. 20 non-hospitalised patients with IF from a regional referral centre will be recruited to assess the utility of urine chloride dipsticks over a 4-week period. These participants will record qualitative data on the dipstick technique with symptom scores, and provide urine samples to analyse the correlation and inter-rater agreement of dipstick versus standard laboratory techniques. This study will receive funding and support from The NHS Acorn Innovation Fund, the NIHR Biomedical Research Unit, and Dr Tyrrell-Price’s discretionary research fund.\n\nBy assessing the feasibility of their use in this patient population, urine chloride dipsticks might prove to be affordable, easy to adopt and objective markers of dehydration that can be used in the home artificial nutrition patient community. This has the potential for clinical benefit through the timely initiation of appropriate hydration therapy, enhanced patient independence and health system cost savings through any avoidance of hospitalisation. \n
REC name
South West - Frenchay Research Ethics Committee
REC reference
17/SW/0175
Date of REC Opinion
9 Oct 2017
REC opinion
Further Information Favourable Opinion