Effect of Sodium Concentration of Priming and Rinsing Fluids on Weight Gain
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.
Fluid Overload and Hypertension in Hemodialysis Patients.
Other: 5% dextrose solution
|Study Design:||Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Effect of Sodium Concentration of Priming and Rinsing Fluids on Interdialytic Weight Gain and Blood Pressure in Hemodialysis Patients: a Prospective Pilot Study|
- Interdialytic weight gain [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Pre and post dialysis blood pressure levels. [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Intradialytic events. [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Thirst levels [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
|Study Start Date:||July 2010|
|Study Completion Date:||November 2012|
|Primary Completion Date:||November 2012 (Final data collection date for primary outcome measure)|
Experimental: 5% dextrose
5% dextrose rinsing fluid
Other: 5% dextrose solution
The extracorporeal circuit of the dialysis machine will be primed and rinsed with a 5% dextrose solution instead of 0.9% saline.
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.
|United States, New York|
|Yorkville Dialysis Center|
|New York, New York, United States, 10128|
|Principal Investigator:||Peter Kotanko, MD||Renal Research Institute|