HFR A-equilibrium on Cardiovascular Stability (AIMS)
Randomized Controlled Study on the Effect of the Hemodiafiltration Plasma Sodium Biofeedback System on Cardiovascular Stability in Hemodialysis Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Online hemodiafiltration (OL-HDF) has been recently associated with better patient survival in comparison with standard hemodialysis in some large observational studies (Canaud et al, KI, 2006; Vilar et al, CJASN , 2009) supporting the hypothesis that convection can improve patients outcomes. Moreover, it has been demonstrated in randomized controlled trials (Locatelli et al, Journal American Society of Nephrology, 2010) that OL-HDF significantly reduced the frequency of intradialytic hypotension. Nonetheless, the associated comorbidities and ageing of dialysis population require further devices able to improve treatment tolerance. Among these tools, the sodium profiling and biofeedback system seem to be promising to accomplish this task. But the correct intradialytic sodium balance is still far away today to be easily achieved. The use of an automated adaptive system dialysis to the sodium profiling has been investigated in a feasibility trial (Colì et al International Journal Artificial Organs, 2003). They also investigated the impact of such a device on treatment tolerance.
The aim of this randomized multinational multicenter controlled trial is to evaluate the impact of sodium profiling applied to a endogenous hemodiafiltration technique on the intradialytic cardiovascular stability in comparison to standard no profiled endogenous hemodiafiltration.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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Bruxelles, Belgium
- Hospital Erasme
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Paris, France
- Dept. of Nephrology and Dialysis Centre Pasteur Vallery Radat
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Vannes, France
- Civil Hospital Bretagne Atlantique
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Rostock, Germany
- Clinic of Internal Medicine
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Ancona, Italy
- Nephrology and Dialysis Unit Ospedali Riuniti
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Bologna, Italy, 40128
- UO Nefrologia Dialisi e Trapianto Policlinico S. Orsola Malpighi
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Ciriè, Italy
- Civil Hospital
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Foggia, Italy
- PO Lastaria
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Novara, Italy
- Hospital Maggiore della Carità
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San Giovanni Rotondo, Italy
- Casa Sollievo della Sofferenza
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Torino, Italy
- Ospedale San Giovanni Bosco
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Barcellona, Spain
- Hospital Val d'Hebron
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with more than 30% of dialysis complicated by hypotension
- age between 18 and 85 yers
- time on dialysis greater than 6 months
- residual creatinine clearance less than 2 ml/min/1.73 m2
- native fistula or central venous catheter with blood flow rate greater than 250 ml/min
Exclusion Criteria:
- Life expectancy less than 1 year
- solid active neoplasm
- pregnancy
- major event in the previous 3 months (ictus, myocardial infarction, cachexia)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Standard
Standard constant (no profiled) sodium dialysate used during endogenous hemodiafiltration
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Standard constant (no profiled) sodium dialysate used during endogenous hemodiafiltration
Other Names:
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Experimental: Automated profiled
Automate sodium profiling in endogenous hemodiafiltration
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Automated sodium profiling during endogenous reinfusion hemodiafiltration technique.
The device processes the dialysate sodium and ultrafiltration rate during dialysis to achieve a preset sodium target at the end of the treatment.
Sodium dialysate and maximal ultrafiltration rate are constraint within safety limits during dialysis.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of dialysis complicated by at least one hypotension
Time Frame: six months
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Hypotension definition: If predialysis systolic blood pressure greater than100 mmHg then a value during dialysis below 90 mmHg or any systolic blood pressure reduction greater than 25 mmHg in presence of symptoms or If predialysis systolic blood pressure less than 90 mmHg a reduction of at least 10% accompanied by symptoms |
six months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Blood Pressure Intradialytic symptoms
Time Frame: six months
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Systolic, diastolic blood pressures (SBP, DBP) and heart rate (HR) measured at the beginning of each treatment and every 30 minutes till the end of dialysis; intradialytic symptoms (nausea, vomiting, hypotension, headache, cramps) and related clinical interventions.
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six months
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Francesco Locatelli, Prof., Azienda Ospedaliera di Lecco
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- HFR-AE-2006
- HFR-BFBCK0611 (Other Identifier: AOLecco)
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