DKK3 as a Possible Early Warning Sign of Scarring in Peritoneal Dialysis
Measures DKK3 over 12 months in adults on peritoneal dialysis for kidney failure.
Plain-language title generated from the registry record
Registry title: DKK3 as a Biomarker of Peritoneal Fibrosis in Peritoneal Dialysis Patients
Key facts
- Where
- Homburg, GermanySee the site
Where in Germany
- Saarland University Medical CenterHomburg, GermanyNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Universität des Saarlandes
- Trial code
- NCT07806708
- Record updated
- 8 September 2026
- Original description
Peritoneal dialysis (PD) uses the peritoneal membrane as a natural filter to remove waste products from the blood in patients with kidney failure. Over time, the peritoneal membrane can become scarred and less functional - a process called peritoneal fibrosis - which eventually leads to ultrafiltration failure and loss of the PD technique. Currently, there is no reliable early biomarker to detect this process before it causes clinical problems.Read full original descriptionShow less
PERIMARK - DKK3 as a Biomarker of Peritoneal Fibrosis in Peritoneal Dialysis Patients: A Prospective, Monocentric, Exploratory Longitudinal Study With Biobanking
Peritoneal dialysis (PD) uses the peritoneal membrane as a natural filter to remove waste products from the blood in patients with kidney failure. Over time, the peritoneal membrane can become scarred and less functional - a process called peritoneal fibrosis - which eventually leads to ultrafiltration failure and loss of the PD technique. Currently, there is no reliable early biomarker to detect this process before it causes clinical problems.
PERIMARK is a prospective, single-center, observational study investigating whether DKK3 (Dickkopf-3), a protein involved in fibrosis signaling, can serve as an early biomarker of peritoneal membrane deterioration. DKK3 will be measured in urine, peritoneal dialysate and serum at four time points over 12 months (T0: catheter insertion; T1: 12 weeks; T2: 6 months; T3: 12 months). At each follow-up visit, peritoneal membrane function will be assessed by the Modified Peritoneal Equilibration Test (Modified PET) with 3.86% glucose, measuring the sodium dip (ΔDNa) as a marker of aquaporin-1-mediated water transport and D/P creatinine as a marker of small solute transport.
The primary endpoint is the intraindividual change in DKK3/creatinine ratio in urine, dialysate and serum from baseline to 12 months. Secondary endpoints include the correlation of DKK3 with the sodium dip, longitudinal changes in peritoneal transport parameters, and the exploratory question of whether an early DKK3 rise predicts a later decline in aquaporin-1 function.
The study also includes a biobank of serum, urine, dialysate supernatant and cell pellets for possible future analyses. Target enrollment is 25-30 patients.
Inclusion: Age ≥18 years; End-stage renal disease with decision for peritoneal dialysis; PD catheter insertion at Department of Internal Medicine IV, Saarland University Medical Center; Written informed consent obtained at least 24 hours before the first study procedure.
Exclusion: Active malignancy (except basal cell carcinoma of the skin); Age <18 years; Lack of capacity to give informed consent; Pregnancy or breastfeeding; Active peritonitis at time of inclusion; Life expectancy <12 months as assessed by the treating physician; Severe peritoneal adhesions precluding PD catheter insertion (intraoperative assessment).