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Mechanisms and Treatment of Intradialytic Hypertension - Sodium

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City:   Dallas and Irving
State:   Texas
Zip Code:  
Conditions:   Hemodialysis - End-stage Renal Disease - Hypertension - Intradialytic Hypertension
Purpose:   The purpose of this study is to determine the role of dialysate exposure and fluid removal during hemodialysis in the pathophysiology of intradialytic hypertension.
Study Summary:   Specific Aim #1 To determine in a crossover study of 15 maintenance hemodialysis patients with intradialytic hypertension whether standard dialysis with ultrafiltration (dialysate Na of 140), dialysis without ultrafiltration (dialysate Na of 140), or ultrafiltration alone (no dialysate) is associated with the an increase in systolic blood pressure during hemodialysis Specific Aim #2 To determine in a crossover study of 15 maintenance hemodialysis with intradialytic hypertension whether standard dialysis with ultrafiltration, dialysis without ultrafiltration, or ultrafiltration alone is associated with change in either endothelin-1 or nitric oxide during hemodialysis SUBSTUDY AIMS Specific Aim #1 To determine in a randomized 3-week, 2 period crossover study of 15 maintenance hemodialysis patients with intradialytic hypertension whether high vs low dialysate-to-serum Na gradients impairs release of NO, increases ET-1 or causes an acute intradialytic increase in systolic BP,. Specific Aim #2 TO determine in a randomized 16-week, 2-period crossover study of 30 hemodialysis patients with intradialytic hypertension the effects of 8 weeks of high dialysate-to-plasma Na gradients to 8-weeks of low Na gradients on EC function (FMD and ADMA) and 44 hour ambulatory BP.
Criteria:   Inclusion Criteria: - on hemodialysis > 30 days - male and female participants, aged 18 to 85 years old, of all races and ethnic origin - ability to provide informed consent - Primary nephrologist deems patient is at target dry weight - KDOQI defined hypertension (predialysis SBP >140 or postdialysis SBP>130) AND - pre to post hemodialysis SBP increase (>10 mmHg) during 4/6 last HD session Exclusion Criteria: - Patients with active cancer or active wounds - Patient currently on antibiotics or on IV antibiotics within the last month - BP unable to be measured by routine mechanisms in the upper extremity - Life expectancy < 6 months - Inability to provide informed consent - Larger interdialytic weight gain (>5 kg/treatment on average)
NCT ID:   NCT01371890
Primary Contact:   Principal Investigator
Jula K Inrig, MD, MHS
UT Southwestern Medical Center

Backup Contact:   N/A
Location Contact:   Dallas and Irving, Texas
United States

Jula Inrig, MD, MHS
Phone: 214-645-8263

Site Status: Recruiting

Data Source:   ClinicalTrials.gov
Date Processed:   May 24, 2013
Modifications to this listing:   Only selected fields are shown, please use the link below to view all information about this clinical trial.
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