A Pilot Study of a Heparin Dosing Algorithm for Hemodialysis
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| ClinicalTrials.gov Identifier: NCT01181544 |
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Recruitment Status :
Completed
First Posted : August 13, 2010
Last Update Posted : May 8, 2017
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Sponsor:
Baxter Healthcare Corporation
Collaborators:
University of Louisville
Gambro Renal Products, Inc.
Information provided by (Responsible Party):
Baxter Healthcare Corporation
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Brief Summary:
During hemodialysis treatments, patients receive heparin to prevent clotting. The purpose of this pilot study is to determine if the amount of heparin administered during a patient's hemodialysis can be individualized using an equation for heparin dose adjustment.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Renal Failure Chronic Requiring Hemodialysis | Procedure: Heparin dose titration | Not Applicable |
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 5 participants |
| Allocation: | N/A |
| Intervention Model: | Single Group Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | Heparin Dose Reduction During Hemodialysis With the Gambro Revaclear and Revaclear MAX Hemodialyzers: Pilot Study I and II |
| Study Start Date : | March 2011 |
| Actual Primary Completion Date : | August 2011 |
| Actual Study Completion Date : | August 2011 |
Resource links provided by the National Library of Medicine
| Arm | Intervention/treatment |
|---|---|
| Experimental: Heparin dose titration |
Procedure: Heparin dose titration
Patients will begin the study using their currently prescribed heparin doses - both bolus and constant infusion - for three treatments to establish a baseline and provide information on inter-treatment variability in dialyzer clotting. Subsequently, the bolus and infusion rates will be titrated either upward or downward based on the Robbins-Monro process and an evaluation of dialyzer clotting during the preceding treatment. Heparin doses will be adjusted for a total of 30 dialyses. |
Primary Outcome Measures :
- Change in dialyzer blood compartment volume when the heparin dose is adjusted using a Robbins-Monro algorithm [ Time Frame: up to 8 weeks ]The objective is to titrate each patient's heparin dose to the level that achieves adequate anticoagulation for that patient as assessed by the change in blood compartment volume of the dialyzer from pre- to post-dialysis. The strategy that will be used is the Robbins-Monro stochastic approximation algorithm.
Secondary Outcome Measures :
- Evaluation of dialyzer performance and visual assessment of clotting in the fiber bundle and the arterial and venous headers [ Time Frame: up to 8 weeks ]Visual assessment of the dialyzer,measurement of ionic dialysance and ionic Kt/V.
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Adults 18 years of age or older
- Stable hemodialysis prescription prior to study enrollment
- Dialyzing through a native fistula or Gore-Tex graft
- Blood access must be able to provide a blood flow rate of 400 ml/min
Exclusion Criteria:
- Non-compliance with dialysis
- Hematocrit less than 28%
- Active Infection
- Diagnosis of Heparin-Induced Thrombocytopenia (HIT)
Information from the National Library of Medicine
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01181544
Locations
| United States, Kentucky | |
| University of Louisville | |
| Louisville, Kentucky, United States, 40202-1718 | |
Sponsors and Collaborators
Baxter Healthcare Corporation
University of Louisville
Gambro Renal Products, Inc.
Investigators
| Principal Investigator: | Richard A. Ward, Ph.D. | University of Louisville |
Publications:
Robbins H, Monro S. A stochastic approximation method. Ann Math Stat 22:400-407, 1951.
Association for the Advancement of Medical Instrumentation: Reuse of Hemodialyzers (ANSI/AAMI RD47:2003). Association for the Advancement of Medical Instrumentation, Arlington, VA, 2003.
| Responsible Party: | Baxter Healthcare Corporation |
| ClinicalTrials.gov Identifier: | NCT01181544 |
| Other Study ID Numbers: |
Gambro PI 2012 |
| First Posted: | August 13, 2010 Key Record Dates |
| Last Update Posted: | May 8, 2017 |
| Last Verified: | May 2017 |
Keywords provided by Baxter Healthcare Corporation:
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Anticoagulation Heparin Hemodialysis Dialysis Renal Dialysis |
Additional relevant MeSH terms:
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Kidney Failure, Chronic Renal Insufficiency Kidney Diseases Urologic Diseases Renal Insufficiency, Chronic |
Heparin Anticoagulants Fibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action |