- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02182089
Measuring Cardiovascular Stress in Patients on Hemodialysis Study II
Study Overview
Status
Detailed Description
Specific Aims are as follows:
- Assess the accuracy of a new rule set for CVInsight® in predicting intradialytic hypotensive episodes.
- Assess the comparative predictive accuracy of CVInsight® to other measures with regard to intradialytic hypotensive events.
- Assess estimated dry weight goals by monitoring post-dialytic vascular refill using CVInsight® and other measures.
- Assess hemodialysis(HD)-induced myocardial injury by monitoring the occurrence and frequency of arrhythmias and the levels of cardiac Troponin T.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Study Population:
The sample will be enriched for subjects prone to IDH, defined as patients who experience IDH for greater than 20% of HD treatments in the past 2 months. The study population will consist of 48 patients total, 75% of patients (n=36) prone to IDH and 25% of patients with less than 10% of IDH during the last two months (n=12).
Description
Inclusion Criteria:
Eligibility shall consist of the following:
- Age ≥ 20 years old
- Speaks and understands English, Spanish or Chinese
- Provides Informed Consent
- Patients with 20% intradialytic hypotensive events over the last two months.
Exclusion criteria for both groups:
- Unstable hemodialysis patients per judgment of the clinician prior to the start of the treatment
- Patients unable to have blood pressure cuff measured on the upper arm
- Inability to wear monitor on forehead
- Patients treated with sodium or ultrafiltration profiling and the patient's nephrologist is unwilling to alter this for the study treatments
- Patients unwilling to shave the anterior chest
- Patients with active infection of the upper chest wall tissue.
- Patients with a deep brain stimulator, as it may disrupt the quality of the ECG data.
- Patients who are unwilling to take short showers versus bathing during the 7 day period .
- Patients who require intradialytic testing (ie transonic) during the monitored treatment.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Dialysis patients with greater than 20% IDH
Study Population: The sample will be enriched for subjects prone to IDH, defined as patients who experience IDH for greater than 20% of HD treatments in the past 2 months. The study population will consist of 48 patients total, 75% of patients (n=36) prone to IDH and 25% of patients with less than 10% of IDH during the last two months (n=12). |
Patients with less than 10% IDH
Study Population: The sample will be enriched for subjects prone to IDH, defined as patients who experience IDH for greater than 20% of HD treatments in the past 2 months. The study population will consist of 48 patients total, 75% of patients (n=36) prone to IDH and 25% of patients with less than 10% of IDH during the last two months (n=12). |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of intradialytic hypotensive (IDH) episodes that can be detected by the new rule set for CVInsight.
Time Frame: 3-4 hours, for two hemodialysis session, or 6-8 hours total
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IDH defined by at least one of the following: 1) Symptoms of hypotension: dizziness, cramping, altered consciousness, nausea +/- vomiting (new since beginning of session), chest pain, shortness of breath, seizure, diaphoretic. 2) Intervention administered due to IDH; relevant interventions:a) a reduction in ultrafiltration (UF) goal programmed at start of treatment (tx); b) admin. of IV fluid, e.g. saline, mannitol or hypertonic saline; c) stopping tx early due to IDH symptoms or event. 3) A significant drop in blood pressure, regardless of symptoms, defined as:
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3-4 hours, for two hemodialysis session, or 6-8 hours total
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The comparative, predictive accuracy of CVInsight® and CRIT-LINE III with regard to intradialytic hypotensive events.
Time Frame: 3-4 hours, for two hemodialysis session, or 6-8 hours total
|
CVInsight® and CRIT-LINE III will have different predictive accuracies in recognizing IDH episodes. Receiver Operator Characteristics analysis of CVInsight and CRIT-LINE CVInsight: Event level thresholds will be triggered based upon new proprietary rule set. CRIT-LINE: Change in hematocrit of 8% per hour or 15% over the treatment. |
3-4 hours, for two hemodialysis session, or 6-8 hours total
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Amount of post-dialytic vascular refill as separately indicated by both CVInsight® and CRIT-LINE III.
Time Frame: At the end of each dialysis session after the ultrafiltration rate (UFR) has turned off.
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Post-dialytic vascular refill will indirectly reflect hydration status and accuracy of dry weight estimation. Vascular refill -Ten minutes prior to the end of treatment, with UFR at zero, and BFR at same rate as during treatment, measurements will continue to be taken via the CVInsight® and CRIT-LINE devices to assess vascular refill. CVInsight: Increase in pulse amplitude. CRIT-LINE: Increase of 0.5% increase in hematocrit (HCT) over 10 minutes. |
At the end of each dialysis session after the ultrafiltration rate (UFR) has turned off.
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The occurrence and frequency of arrhythmias as indicated on the Zio ECG Patch and the levels of cardiac Troponin T, taken prior to each HD treatment. which are indicative HD-induced myocardial injury..
Time Frame: 24 hours before first session of monitored dialysis to at least 24 hours after the second session on monitored dialysis sessions.
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Arrhythmias frequency overall, on dialysis days, during long and short interdialytic periods, nocturnal, diurnal.
Troponin T levels will correlate with the incidence rates of arrhythmias.
Troponin T as measured by ng/mL, reference value at <0.011
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24 hours before first session of monitored dialysis to at least 24 hours after the second session on monitored dialysis sessions.
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IntelomedTufts11231
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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