Altering Bicarbonate Delivery During Hemodialysis to Affect Filtration of Indoxyl Sulfate
| Status: | Recruiting |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease, Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 4/21/2016 |
| Start Date: | January 2016 |
| End Date: | May 2016 |
| Contact: | Eric Grossman, MD |
| Email: | grosse04@nyumc.org |
This is a non randomized crossover trial investigating whether changing the pattern of
bicarbonate administration during hemodialysis will result in the more efficient filtration
of highly protein bound solutes. The experimental group will be dialyzed with low
bicarbonate dialysate for the first half of dialysis then switched over to normal
bicarbonate dialysate for the second half. The control group will be dialyzed entirely with
normal bicarbonate dialysate. The two groups will switch one week late and patients will
serve as their own matched controls for a completely standard dialysis and one that is split
into two halves with different bicarbonate concentrations.
bicarbonate administration during hemodialysis will result in the more efficient filtration
of highly protein bound solutes. The experimental group will be dialyzed with low
bicarbonate dialysate for the first half of dialysis then switched over to normal
bicarbonate dialysate for the second half. The control group will be dialyzed entirely with
normal bicarbonate dialysate. The two groups will switch one week late and patients will
serve as their own matched controls for a completely standard dialysis and one that is split
into two halves with different bicarbonate concentrations.
Investigators will try to perform dialysis with a low bicarbonate bath which will leave
patients blood pH (Hydrogen ion concentration) relatively unchanged then switch to a normal
bicarbonate bath during the second half of dialysis so that they attain the pH (Hydrogen ion
concentration) they normally would. Investigators will use these measurements to test test
the hypothesis that Indoxyl Sulfate (IS) binds to proteins with greater affinity under basic
conditions and further to test the hypothesis that it is possible to remove a greater amount
of Indoxyl Sulfate (IS) when patients are maintained relatively acidotic during dialysis for
a longer period of time due to the greater availability of free IS that can pass through the
dialyzer.
patients blood pH (Hydrogen ion concentration) relatively unchanged then switch to a normal
bicarbonate bath during the second half of dialysis so that they attain the pH (Hydrogen ion
concentration) they normally would. Investigators will use these measurements to test test
the hypothesis that Indoxyl Sulfate (IS) binds to proteins with greater affinity under basic
conditions and further to test the hypothesis that it is possible to remove a greater amount
of Indoxyl Sulfate (IS) when patients are maintained relatively acidotic during dialysis for
a longer period of time due to the greater availability of free IS that can pass through the
dialyzer.
Inclusion Criteria:
- Chronic Stable Dialysis for at least 6 months
Exclusion Criteria:
- Patients with serum potassium concentration below 4.0 mEq/L on previous monthly lab
test or corrected serum calcium below 8.5 mEq/L
- Hospitalization within the past 12 months
- Adults unable to consent
- Children
- Pregnant women
- Prisoners
We found this trial at
1
site
550 1st Ave
New York, New York 10016
New York, New York 10016
(212) 263-7300
Principal Investigator: Jerome Lowenstein, MD
New York University School of Medicine NYU School of Medicine has a proud history that...
Click here to add this to my saved trials
