End Stage Renal Disease Clinical Trial
Official title:
Effects of On-Line Hemodiafiltration(HDF) on Endothelial Dysfunction in Chronic Hemodialysis Patients
The purpose of this study is to determine whether on-line hemodiafiltration ameliorate the endothelial dysfunction compared with the low flux hemodialysis in end stage renal disease patients on maintenance hemodialysis.
1. On-line hemodiafiltration(OL-HDF) is a technique that combines diffusion with convection
in which the large substitution fluid is produced directly from the dialysate. It offers
many advantages aside from its safe inflammatory profile, which is attributable to the
use of ultrapure dialysate and highly biocompatible dialysis membranes. Due to an
improved convective clearance, significantly increased removal of large or protein-bound
uremic retention solutes can be achieved, with a potential benefit on cardiovascular
morbidity and mortality.
2. Endothelial dysfunction, almost universal in end stage renal disease, is important risk
factor for cardiovascular events, and can be evaluated by brachial artery
endothelium-dependent vasodilation (flow-mediated dilation) to reactive hyperemia
following 5 min of forearm ischemia.
3. The stable HD patients will receive 8-week treatment on OL-HDF or conventional low flux
HD and then crossed over to opposite treatment arm. The FMD will be measured by one
sonographer, and at the same time whole blood and serum will be sampled and stored for
further analysis. The timepoint for measurement is 4-week interval after baseline
evaluation.
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