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- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT01125202
Intervention to Reduce Dietary Sodium in Hemodialysis (BalanceWise-HD)
14 de agosto de 2017 actualizado por: Mary Ann Sevick, University of Pittsburgh
The purpose of this study is to test, in a randomized clinical trial of 200 hemodialysis patients, a behavioral intervention to reduce dietary sodium intake.
The investigators will assess the impact on weight gain between dialysis treatments, blood pressures, symptoms, and health-related quality of life.
The primary study hypotheses are that participants will gain less weight in between dialysis treatments, and that dietary recalls will demonstrate reduced consumption of dietary sodium.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
Cardiovascular disease is the single most common cause of death in hemodialysis (HD) patients.
Most HD patients have left ventricular hypertrophy(LVH), a significant predictor of death in this population.
LVH is related to extracellular volume expansion and hypertension, both of which are amenable to dietary sodium restriction.
However, dietary change is widely known to be difficult to achieve and sustain.
Controlling dietary sodium is particularly difficult for HD because many foods are naturally high in sodium, and most prepared/prepackaged foods have significant amounts of sodium added to enhance taste and shelf-life.
Research on behavioral methods that are effective in reducing dietary sodium intake in HD is very limited.
The purpose of this study is to test, in a randomized clinical trial of 200 HD patients, a behavioral intervention, paired with personal digital assistant (PDA)-based dietary self-monitoring, to enhance adherence to dietary sodium restrictions.
Specifically the investigators will: (a) Assess the impact of the intervention on average daily interdialytic weight gains (IDWG-A).
(b) Examine the impact of the intervention on self-reported dietary sodium intake.
The study hypotheses are that compared to the control group, the intervention group will: (1) demonstrate a statistically significant decline in IDWG-A over the 4-month intervention period, and (2) experience a greater decline in dietary sodium intake.
Secondarily, the investigators will explore the impact of the intervention on: (a) pre-dialysis pulse pressure and mean arterial blood pressure, (b) hemodialysis dietary self-efficacy, and (c) intradialytic and postdialytic symptoms and general health-related quality of life.
In addition, the investigators will characterize the barriers/facilitators to adherence to the HD dietary regimen and patient experience of the intervention through the use of qualitative methods.
The intervention is based on Social Cognitive Theory (SCT).
Self-monitoring within the context of the intervention is operationalized as PDA-based dietary recording using BalanceLog software.
Participants randomized to the attention control will receive computerized dietary education.
Attention control participants will be offered an abbreviated version of the intervention after the 4-month study period concludes.
Differences in IDWG-A, pulse pressure, and mean arterial pressure will be examined using a random intercept linear regression modeling.
Self-reported dietary sodium, self-efficacy, symptoms, and quality of life will be assessed at baseline, 6 weeks, and 4 month and differences will be examined using repeated measures modeling using GEE.
Qualitative analysis of narrative data will be performed.
Tipo de estudio
Intervencionista
Inscripción (Actual)
179
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Pennsylvania
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Pittsburgh, Pennsylvania, Estados Unidos, 15213
- University of Pittsburgh School of Medicine
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Individuals with end stage renal disease (ESRD) who are 18 years of age or older,
- Individuals who are literate,
- Community-dwelling adults who have been receiving maintenance dialysis for at least 3 months.
Exclusion Criteria:
- Individuals who cannot read or write,
- Individuals who do not speak English,
- Individuals who plan to move out of the area or change dialysis centers within the next 6 months,
- Individuals who have a life expectancy of less than 12 months,
- Individuals who are scheduled for a living donor transplant,
- Individuals who cannot see the PDA screen or use the stylus to make food selections from the PDA screen, or
- Individuals who live in an institutional setting in which they would have limited control over their dietary intake.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Experimental: SCT-based behavioral intervention
Intervention participants continue to receive routine dialysis care, as well as a 16 week dietary counseling intervention based on Social Cognitive Theory.
Dietary counseling is paired with Personal Digital Assistant-based dietary self-monitoring.
|
Intervention group continues to receive routine dialysis care.
The intervention duration is 16 weeks.
Intervention contacts are 2x/week for weeks 0-8, weekly for weeks 9-12, and every other week for weeks 13-16.
Personal digital assistant dietary records are use to provide targeted counseling and engaged the participant in problem solving around dietary issues.
|
Comparador activo: Attention control
Attention control participants continue to receive routine dialysis care.
Attention control participants view 5 computerized educational programs PowerPoint slides) that summarize the various elements of the HD diet.
The 5 modules evenly over the 4-month study period.
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Attention control participants continue to receive routine dialysis care.
Attention control participants view 5 computerized educational programs PowerPoint slides) that summarize the various elements of the HD diet.
The 5 modules evenly over the 4-month study period.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Time Specific Interdialytic Weight Gain (Baseline)
Periodo de tiempo: Baseline
|
Average interdialytic weight gains (kg/day) were calculated for the 1 week period prior to baseline measurement.
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Baseline
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Time Specific Interdialytic Weight Gain (8 Weeks)
Periodo de tiempo: 8 weeks
|
Average interdialytic weight gains (kg/day) were calculated for the 1 week period prior to the 8-week measurement time point.
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8 weeks
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Time Specific Interdialytic Weight Gain (12 Weeks)
Periodo de tiempo: 12 weeks
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Average interdialytic weight gains (kg/day) were calculated for the 1 week period prior to the 12 week measurement time point.
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12 weeks
|
Time Specific Interdialytic Weight Gain (16 Weeks)
Periodo de tiempo: 16 weeks
|
Average interdialytic weight gains (kg/day) were calculated for the 1 week period prior to the 16 week measurement time point.
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16 weeks
|
Time Specific Dietary Sodium Intake (Baseline)
Periodo de tiempo: Baseline
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Dietary sodium intake was assessed via three 24-hour dietary recalls, including 1 dialysis weekday, 1 non-dialysis weekday, and 1 non dialysis weekend day.
Recalls were entered into Nutrition Data System for Research, with sodium intake averaged across the 3 recalls.
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Baseline
|
Time Specific Dietary Sodium Intake (8 Weeks)
Periodo de tiempo: 8 weeks
|
Dietary sodium intake was assessed via three 24-hour dietary recalls, including 1 dialysis weekday, 1 non-dialysis weekday, and 1 non dialysis weekend day.
Recalls were entered into Nutrition Data System for Research, with sodium intake averaged across the 3 recalls.
|
8 weeks
|
Time Specific Dietary Sodium Intake (16 Weeks)
Periodo de tiempo: 16 weeks
|
Dietary sodium intake was assessed via three 24-hour dietary recalls, including 1 dialysis weekday, 1 non-dialysis weekday, and 1 non dialysis weekend day.
Recalls were entered into Nutrition Data System for Research, with sodium intake averaged across the 3 recalls.
|
16 weeks
|
Time Specific Change From Baseline in Dietary Sodium Intake (Baseline to 8 Weeks)
Periodo de tiempo: Baseline to 8 weeks
|
Dietary sodium intake was assessed via three 24-hour dietary recalls, including 1 dialysis weekday, 1 non-dialysis weekday, and 1 non dialysis weekend day.
Recalls were entered into Nutrition Data System for Research, with sodium intake averaged across the 3 recalls.
The difference between measurement time points was determined.
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Baseline to 8 weeks
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Time Specific Change From Baseline in Dietary Sodium Intake (Baseline to 16 Weeks)
Periodo de tiempo: Baseline to 16 weeks
|
Dietary sodium intake was assessed via three 24-hour dietary recalls, including 1 dialysis weekday, 1 non-dialysis weekday, and 1 non dialysis weekend day.
Recalls were entered into Nutrition Data System for Research, with sodium intake averaged across the 3 recalls.
|
Baseline to 16 weeks
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Publicaciones Generales
- McMahon EJ, Campbell KL, Bauer JD, Mudge DW, Kelly JT. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2021 Jun 24;6(6):CD010070. doi: 10.1002/14651858.CD010070.pub3.
- Sevick MA, Piraino BM, St-Jules DE, Hough LJ, Hanlon JT, Marcum ZA, Zickmund SL, Snetselaar LG, Steenkiste AR, Stone RA. No Difference in Average Interdialytic Weight Gain Observed in a Randomized Trial With a Technology-Supported Behavioral Intervention to Reduce Dietary Sodium Intake in Adults Undergoing Maintenance Hemodialysis in the United States: Primary Outcomes of the BalanceWise Study. J Ren Nutr. 2016 May;26(3):149-58. doi: 10.1053/j.jrn.2015.11.006. Epub 2016 Feb 9.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de septiembre de 2009
Finalización primaria (Actual)
1 de septiembre de 2012
Finalización del estudio (Actual)
1 de septiembre de 2012
Fechas de registro del estudio
Enviado por primera vez
14 de mayo de 2010
Primero enviado que cumplió con los criterios de control de calidad
17 de mayo de 2010
Publicado por primera vez (Estimar)
18 de mayo de 2010
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
15 de agosto de 2017
Última actualización enviada que cumplió con los criterios de control de calidad
14 de agosto de 2017
Última verificación
1 de agosto de 2017
Más información
Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- PRO08040361
- R01NR010135 (Subvención/contrato del NIH de EE. UU.)
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
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