- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07637110
Dry Weight Reduction Intervention Via Extra Ultrafiltration (DRIVE-UF)
Most patients who receive hemodialysis treatments have excess fluid in their body that has slowly built up over the course of kidney disease. This extra fluid is the main cause of high blood pressure in dialysis and leads to stress on the heart and lungs.that causes debilitating symptoms and frequent hospitalizations.
This trial will test whether a focused program of 4 or 8 weeks of extra ultrafiltration treatments can remove most of this extra fluid. We believe that getting rid of large amounts of extra fluid will result in sustained improvements in blood pressure and symptoms. Ultrafiltration is a gentler type of dialysis that removes fluid but does not clean the blood.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
This is a randomized trial of patients who are receiving in-center hemodialysis treatments for end stage kidney disease and have clinical suspicion of fluid overload. Enrolled participants will be randomly assigned in 1:1:1 fashion to either a four-week ultrafiltration strategy, an eight-week ultrafiltration strategy, or continuation of their regular thrice weekly hemodialysis treatments. Each ultrafiltration strategy will add two extra four-hour ultrafiltration treatments per week plus pharmacist-guided tapering of blood pressure medications. We will test the impact of these strategies on primary outcomes of
- Change in 24-hour continuous ambulatory blood pressure from baseline to 24-weeks
- Change in symptoms of congestion from baseline to 24-weeks We will also test the impact of the treatment strategies on related symptoms, physical activity levels, hemodynamics. and measures of safety.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Ernest Ayers, MSPH
- Numéro de téléphone: 206-685-1423
- E-mail: ayerse@uw.edu
Sauvegarde des contacts de l'étude
- Nom: Luisa Rios-Avila
- Numéro de téléphone: 206-258-9325
- E-mail: lrios1@uw.edu
Lieux d'étude
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Washington
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Seattle, Washington, États-Unis, 98112
- Northwest Kidney Centers
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Contact:
- Luisa Rios-Avila
- Numéro de téléphone: 2062589325
- E-mail: lrios1@uw.edu
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
Receiving thrice weekly in-center hemodialysis treatments for end stage kidney disease for at least four weeks and clinical suspicion of volume excess based on either:
Persistent hypertension defined by three consecutive pre-dialysis systolic blood pressures ≥140 mmHg or three consecutive pre-dialysis systolic blood pressures 130-140 mmHg plus use of at least two anti-hypertensive medications that can be tapered.
OR
Symptoms of congestion defined by a 12-item Kidney Modified Kansas City Cardiomyopathy Questionnaire (KM-KCCQ) score <75.
Exclusion Criteria:
- Age <18 years
- Receiving hemodialysis treatments for acute kidney injury
- Receiving hemodialysis treatments for less than four weeks
- Planned switch to peritoneal or home dialysis within next three months
- Current or planned incremental hemodialysis (less than 3 treatments per week)
- Current or planned intensive hemodialysis (four or more treatments per week)
- Scheduled kidney transplantation
- Major cardiovascular or bleeding event within previous 90 days
- Receiving chemotherapy or radiation treatment for cancer
- History of cirrhosis with ascites
- Inability to complete 24-hour ambulatory blood pressure measurement
- Wheelchair dependance or other inability to complete six-minute walk test
- Pre-dialysis systolic blood pressure <100 mmHg
- Scheduled use of midodrine with hemodialysis treatments
- History of non-adherence with dialysis treatments
- Pregnancy
- Institutionalized
- Current or pending enrollment in hospice care
- Inappropriate for enrollment based on investigator or nephrologist discretion
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Comparateur actif: Ultrafiltration sessions for 4 weeks
Two ultrafiltration sessions per week plus pharmacist guided tapering of blood pressure medications in addition to the regular thrice weekly hemodialysis treatments.
|
Ultrafiltration for 4 or 8 weeks compared to no ultrafiltration.
|
|
Comparateur actif: Ultrafiltration sessions for 8 weeks
Two ultrafiltration sessions per week plus pharmacist guided tapering of blood pressure medications in addition to the regular thrice weekly hemodialysis treatments.
|
Ultrafiltration for 4 or 8 weeks compared to no ultrafiltration.
|
|
Aucune intervention: Control arm, no ultrafiltration sessions
Participant receives only their regularly scheduled thrice weekly hemodialysis treatments.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
24-hour continuous ambulatory blood pressure
Délai: Measurement performed at baseline compared to measurement performed at 24 weeks.
|
Blood pressure measured continously for a 24-hour period by wearing a blood pressure cuff on the upper arm.
|
Measurement performed at baseline compared to measurement performed at 24 weeks.
|
|
Symptoms of congestion.
Délai: Questionnaire taken at Baseline compared the the questionnaire taken at 24 weeks.
|
Change in sypmtoms of congestion caused by fluid overload which we will access by using the Kidney-modified Kansas City Cardiomyopathy Questionnaire.
|
Questionnaire taken at Baseline compared the the questionnaire taken at 24 weeks.
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Bryan Kestenbaum, MD, MS, University of Washington
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Maladies urogénitales
- Maladies vasculaires
- Maladies cardiovasculaires
- Processus pathologiques
- Maladies urogénitales masculines
- Maladies rénales
- Maladies urologiques
- Maladies urogénitales féminines
- Maladies urogénitales féminines et complications de la grossesse
- Maladie chronique
- Attributs de la maladie
- Insuffisance rénale
- Insuffisance rénale chronique
- Conditions pathologiques, signes et symptômes
- Signes et symptômes
- Hypertension
- Insuffisance rénale chronique
- Œdème
- Techniques d'investigation
- Procédures chirurgicales, opératoires
- Phénomènes physiques
- Filtration
- Techniques de chimie, analytique
- Phénomènes chimiques
- Circulation extracorporelle
- Ultrafiltration
Autres numéros d'identification d'étude
- STUDY00025083
- R01DK141693 (Subvention/contrat des NIH des États-Unis)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
All data and samples will be stored indefinitely for possible future uses. There will be no direct or indirect identifiers stored with the resources after this study is finished.
Resources will be coded with study codes. We plan post de-identified data in public databases such as Dryad at study conclusion.
NIH data sharing policies typically require us to post coded, deidentified individual-level data on one of the preferred platforms. We will work with our NIH project officer to post data after the study is finished to an appropriate platform.
We may collaborate with colleagues and other researchers who demonstrate a legitimate research need for which data and samples from this study would be valuable.
Future uses do not have any restrictions.
Délai de partage IPD
Type d'informations de prise en charge du partage d'IPD
- PROTOCOLE D'ÉTUDE
- SÈVE
- CIF
- ANALYTIC_CODE
Informations sur les médicaments et les dispositifs, documents d'étude
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