End Stage Renal Disease Clinical Trial
Official title:
Randomized Study of Standard vs High Amount of Hemodialysis Using Low vs High Flux Dialyzer Membranes for End Stage Renal Disease
OBJECTIVES: I. Evaluate whether hemodialysis providing a 2-pool, variable volume urea kinetic
modelling value of 1.05 versus 1.45 reduces mortality and morbidity in patients with end
stage renal disease.
II. Compare the efficacy of high versus low flux dialyzer membranes.
PROTOCOL OUTLINE: This is a randomized, multicenter study. Patients are stratified by center,
age, and diabetes prior to dialysis initiation.
Patients are randomly assigned to 1 of 4 groups: moderate dose dialysis, low flux membrane;
high dose dialysis, low flux membrane; moderate dose dialysis, high flux membrane; or high
dose dialysis, high flux membrane. Moderate dose is a target eKt/V of 1.05 and high dose is
1.45. The dose and delivery of dialysis are measured monthly by the equilibrated fractional
clearance of urea (eKt/V) calculated with double pool kinetics.
Patients are dialyzed 3 times a week in the shortest possible time (minimum 2.5 hours),
adjusted for adequate fluid removal. General medical care, protein and calorie intake, and
dialyzer reuse and other aspects of dialysis therapy are standardized. The protocol document
lists approved dialyzers; no unsubstituted cellulosic membranes are permitted.
The intervention phase of this study is 5 years. Patients are followed for survival.
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