Hemodialysis Patients Clinical Trial
Official title:
Removal of Ligand-bound Iron During Intravenous Iron Administration in Hemodialysis by Large Pore Dialyzers
The study's hypothesis is that HD with large pore dialyzers remove to the dialysate iron which is bound to potentially dialyzable ligands, after it's release from intravenous iron compound administered during hemodialysis.
Most hemodialysis(HD) patients receive during HD intravenous iron compounds, which are
composed of an iron core and a sugar polymer shell.
A small percentage of iron from the iron compound is released to the plasma, and may be
associated with increased oxidative stress and protein oxidation. The study's hypothesis is
that HD with large pore dialyzers may remove to the dialysate iron which is bound to
potentially dialyzable ligands, after it's release from intravenous iron compound
administered during hemodialysis.
Ligand-bound iron removal is also hypothesized to be affected by dialysate calcium and
bicarbonate concentrations, which may affect iron-ligand binding.
Study Specific aims are:
To evaluate
1. Iron removal assessing dialysate iron levels.
2. Effect of iron removal and it's associated experimental conditions on patient status,
assessing plasma AOPP levels and inflammation related parameters
Study include 3 parts
1. Comparing large to small pore dialyzers
(To achieve baseline uniform conditions, patients will be on uniform dialysate
bicarbonate and calcium concentrations of 33 mEq/L and 3 mEq/L,respectively, using
large pore dialyzers during this part, besides the 2 HD sessions evaluating low pore
dialyzers)
and after few week break
Using large pore dialyzers to compare
2. Low to high dialysate bicarbonate concentration (using uniform dialysate calcium
concentrations of 3 mEq/L)
and after few week break
3. Low to high dialysate calcium concentrations concentration (using uniform dialysate
bicarbonate of 33 mEq/L)
In each part, patients will be first evaluated in HD without IV iron administration, which
will serve as a control for evaluation after a week in HD with IV iron administration.
In each part, patients will be randomized to start either with one of the 2 experimental
conditions, and after 1 week without evaluation will cross-over to the other experimental
condition.
Patients may participate in 1,2 or the 3 parts of study depending on their will and
condition.
;
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Open Label
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