- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05169125
Reducing Dialysate Sodium Effect on Blood Pressure Variability in Hemodialysis Patients
Effect of Reducing Dialysate Sodium Concentration on Blood Pressure Variability in Hemodialysis Patients: A Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Cardiovascular diseases are considered the major cause of mortality in maintenance hemodialysis patients. Nevertheless, hypertension is recognized as an important modifiable risk factor for cardiovascular disease among hemodialysis (HD) patients.
Apart from blood pressure levels, BP variability, which reflects the fluctuation in BP, has been described as an independent risk factor that linearly associated with all-cause and cardiovascular mortality in HD patients.
BPV is categorized as either long or short term, based on the time interval over which it is considered. In the dialysis population, long-term BPV is typically defined on the basis of BP measurements taken at the start of each thrice-weekly hemodialysis treatment (interdialytic BPV). On the other hand, short-term BPV among dialysis patients can be considered in terms of variability that occurs during hemodialysis treatments (intradialytic BPV). Researchers believed that the mitigation strategies of BPV must be paid attention to.
Sodium load is associated with thirst, fluid retention, interdialysis weight gain and hypertension for hemodialysis patients, therefore the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline highlighted the importance of limiting sodium intake and adequate sodium removal which is considered one of the most important goals of the dialysis therapy.
Interestingly, a recent study showed that mild decrease in dialysate sodium concentration could improve systolic blood pressure variability in HD patients at their dry weight, thus improving blood pressure complications and subsequent complications. However, whether improving sodium balance could potentially contribute to better BPV management in HD patients has not been assessed in a randomized manner. Therefore, this study aims to investigate whether lowering dialysate sodium concentration could help mitigate long term (interdialytic) BPV in hemodialysis patients in a randomized controlled manner.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ghada El-said, Ass. Prof.
- Phone Number: 01019080448
- Email: ghadaalsaid222@gmail.com
Study Contact Backup
- Name: Hoda Abdulaziz, Lecturer
- Phone Number: 01002878480
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients' age ≥18 years
- Patients who had been on regular hemodialysis for at least 3 months.
- Patients' residual daily urine output is less than 100 mL/day.
- Pre study one week average systolic BP ≥120 mmHg but ≤ 180 mmHg.
- Patients who have achieved their dry weight as assessed by clinical examination.
- Predialytic serum sodium level ≥ 140mmol/l.
- Kt/V ≥ 1.2
Exclusion Criteria:
- Patients who have advanced heart failure or permanent atrial fibrillation decompensated liver disease, neoplastic illness, overt edema.
- History of acute cardiovascular accidents or infections during 3 months preceding entry into the study.
- Patients prone to hypotension or other intradialytic adverse events.
- Patients participating in another interventional study that may affect blood pressure.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Group A: standard hemodialysis.
patients who will undergo standard hemodialysis (dialysate sodium concentration 143 mmoL/L)
|
patients who will undergo standard hemodialysis (dialysate sodium concentration 143 mmoL/L)
|
Active Comparator: Group B: lower dialysate sodium hemodialysis.
patients who will undergo hemodialysis with lower dialysate sodium concentration (140 mmoL/L).
|
patients who will undergo hemodialysis with lower dialysate sodium concentration (140 mmoL/L)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
blood pressure variability.
Time Frame: 2 weeks after the study duration (3 months).
|
visit to visit blood pressure variability in both groups.
|
2 weeks after the study duration (3 months).
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
interdialytic weight gain
Time Frame: 2 weeks after the study duration (3 months).
|
interdialytic weight gain
|
2 weeks after the study duration (3 months).
|
antihypertensive medication regimen
Time Frame: 2 weeks after the study duration (3 months).
|
antihypertensive medication regimen
|
2 weeks after the study duration (3 months).
|
the frequency of intradialytic adverse events
Time Frame: 2 weeks after the study duration (3 months).
|
the frequency of intradialytic adverse events as hypotensive crises and cramps.
|
2 weeks after the study duration (3 months).
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Ghada El-said, Ass. Prof., Mansoura University
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- MS.21.06.1547
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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