Effect of Sodium Concentration of Priming and Rinsing Fluids on Weight Gain
| Status: | Completed |
|---|---|
| Conditions: | High Blood Pressure (Hypertension), Obesity Weight Loss, Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Endocrinology, Nephrology / Urology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 11/18/2012 |
| Start Date: | July 2010 |
| End Date: | December 2012 |
| Contact: | Georges Ouellet, MD |
| Email: | gouellet@rriny.com |
Effect of Sodium Concentration of Priming and Rinsing Fluids on Interdialytic Weight Gain and Blood Pressure in Hemodialysis Patients: a Prospective Pilot Study
Sodium loading during hemodialysis treatment is common and may contribute to increased
interdialytic weight gain and hypertension. Excessive use of isotonic saline (containing
0.9% sodium chloride) is one of the factors that may cause sodium loading. During each
hemodialysis session, approximately 400 mL of isotonic saline fluid, representing 1.4 grams
of sodium, is used to prime and rinse the extracorporeal circuit, and is often administered
to the patient. Switching to a non sodium-containing priming and rinsing fluid could allow
for removal of the equivalent amount of sodium.
Switching to a non sodium-containing solution for the priming and rinsing of the
extracorporeal circuit can contribute to increased sodium removal during the dialysis
treatment and allow for reduced interdialytic weight gain, reduced thirst, and improved
blood pressure control.
This 12 week study consists of 3 phases:
Phase 1 (4 weeks): Observation only. Standard priming/rinsing procedure with isotonic saline
Phase 2 (4 weeks): Intervention. Switch to a 5% dextrose solution for priming/rinsing
procedure Phase 3 (4 weeks): Switch back to standard priming/rinsing procedure with isotonic
saline During the study, blood pressures will be measured in a standardized manner at 2 week
intervals, a thirst questionnaire will be completed at the end of each phase, and
interdialytic weight gain, in-center pre/post-HD blood pressure and intradialytic symptoms
will be recorded, apart for routinely measured parameters.
Inclusion Criteria:
- Ambulatory, clinically stable maintenance HD patients on a thrice weekly HD regimen.
- Willing and able to provide written, signed informed consent after the nature of the
study has been explained.
- Willing and able to comply with all study procedures.
- Age ≥18 years.
Exclusion Criteria:
- Diabetes mellitus
- Considerable residual renal function (diuresis > 500 mL/day)
- Simultaneous participation in another clinical study except observational trials
- Any psychological condition which could interfere with the patient's ability to
comply with the study protocol
- Expectation that native kidney function will recover
- Impossibility to perform a blood pressure measurement on the upper limb
- Unable to verbally communicate in English
- Scheduled for living donor kidney transplant, change to peritoneal dialysis, home HD
or plans to relocate to another center during the study period.
- Life expectancy < 6 months
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