Patient, carer & clinician perspectives on kidney drainage towards EoL

• Research type

  Research Study

• Full title

  A qualitative evaluation of patient, carer and clinician perspectives on Percutaneous Nephrostomy and Ureteric Stenting for Malignant Upper Tract Obstruction (MUTO)

• IRAS ID

  322510

• Contact name

  Jonathan Aning

• Contact email

  Jonathan.Aning@nbt.nhs.uk

• Sponsor organisation

  Research & Innovation, North Bristol NHS Trust

• Duration of Study in the UK

  1 years, 0 months, 0 days

• Research summary

  Advanced cancer can block the ureter, of one or both kidneys, preventing urine flow and causing kidney failure. This commonly happens in people approaching the end-of-life. Blockage symptoms may include pain, feeling sick/tired and suffering infections.
  There are two treatments available:
  1. Percutaneous Nephrostomy(PCN): the doctor places a tube through the patient’s skin into the kidney whilst awake using local anaesthetic. Urine then drains into a collection bag outside the body.
  2. Retrograde Ureteric Stent insertion(RUS): the doctor places a tube through the bladder into the kidney whilst the patient is asleep. Urine then drains through the ureter.

  It’s not known whether these treatments improve quality-of-life or increase length of life beyond a few weeks/days for people with advanced cancer and we may be doing harm without knowing. These treatments can be troublesome for patients, causing long term pain, inconvenience to daily life including multiple additional hospital and/or GP visits. Over 2900 PCNs are inserted each year for this condition in England. This number is increasing and inter-hospital variation has been demonstrated.

  Limited information exists to help people decide between PCN/RUS/no surgical intervention. Most people with these blockages are treated as an emergency which usually doesn’t allow time to fully consider options. This study aims to investigate the degree to which patients, carers and HCPs value these treatments and their information needs.

• REC name

  Wales REC 4

• REC reference

  23/WA/0060

• Date of REC Opinion

  8 Mar 2023

• REC opinion

  Favourable Opinion