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Hypotension During Dialysis clinical trials

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NCT ID: NCT05872984 Completed - Clinical trials for Hemodialysis Complication

Evaluation of Total Blood Volume Measurement During Dialysis on the Incidence of Intradialytic Hypotension

Start date: July 9, 2020
Phase: N/A
Study type: Interventional

Establishing the euvolemic state in hemodialysis patients -the so called "dry weight"- is an important clinical conundrum in every nephrologist's daily practice. Underestimation of dry weight (with excessive ultrafiltration) results in dialysis-induced hypotension. Currently used methods to establish dry weight, including clinical assessment, bio-impedance spectroscopy and online relative blood volume (RBV) measurements, all have their limitations. RBV measurement reflects changes in blood volume during dialysis without providing any information about the initial hydration status, or the initial absolute blood volume (ABV). Recently, researchers proposed a new method to calculate ABV, by using the principle of dilution-indicator with RBV measurement. In a small cohort study they identified a total blood volume threshold of 65 millilitres per kilogram dry weight predicting for intra-dialytic hypotension associated symptoms. The goal of current clinical trial is to re-investigate the accuracy of the above-described method and to confirm the hypothesis of a critical threshold of 65 ml blood volume per kg dry weight in haemodialysis patients. Researchers will compare adjustment of dry weight based on the ABV measurement with standard care to see if dialysis-induced hypotension will be reduced.

NCT ID: NCT04522635 Completed - Fluid Overload Clinical Trials

Fluid Mobilization in Hospitalized Patients With Acute Kidney Injury

Start date: June 3, 2015
Phase: Phase 4
Study type: Interventional

Hospitalized patients often suffer from an acute shutdown of kidney function secondary to infections, use of antibiotics, or use of intravenous contrast agents. This results in the accumulation of toxic substances and retention of fluid in the body. Dialysis techniques are often needed to manage these patients to remove the retained toxic substances and extra fluid and allow the kidney time to recover. The amount and duration of fluid accumulation have been associated with a higher risk of death and longer hospital stays. Correction of fluid overload with dialysis has been shown to be beneficial in improving the outcomes from these patients. Most patients are quite sick and often have low levels of a blood protein called albumin that makes them more prone to developing low blood pressure during dialysis and limits the ability of dialysis to remove solutes and fluid adequately. Often dialysis sessions are complicated by the development of low blood pressures and symptoms such as nausea, vomiting, and headaches that further compromises dialysis efficacy. In this study, the hypothesis that addition of intravenous albumin during the dialysis session will improve the ability to remove fluid and reduce the incidence of low blood pressure during dialysis thereby improving patient tolerance and the efficacy of the procedure will be tested. Patients with acute kidney failure or end-stage Renal Disease who need dialysis for fluid removal will be allocated to receive albumin or saline as intravenous fluids during individual dialysis sessions and information on how much fluid can be removed and how many complications occur in each session will be recorded. Dialysis sessions with albumin will be compared with those with saline alone to determine the benefit of adding albumin to the treatment. Information obtained from this study will allow physicians to manage patients requiring dialysis for acute kidney failure more effectively and help improve outcomes.

NCT ID: NCT03949088 Not yet recruiting - Clinical trials for Hypotension During Dialysis

Integrated Strategies to Prevent Intradialytic Hypotension (The DialHypot Study)

DialHypot
Start date: June 1, 2019
Phase: N/A
Study type: Interventional

The present study is aimed at comparing different strategies of UF profiling, dialysate sodium individualization and sodium profiling (even combining one with the other) and at evaluating the effectiveness of a new UF profile which has an ascending/descending shape. The goal of the study is to provide better dialysis tolerance and lower rates of intradialytic hypotensive events by the application of this UF profile design in combination with a neutral sodium balance.

NCT ID: NCT03947710 Recruiting - Clinical trials for End Stage Renal Disease

Effect of Protein Intake During Hemodialysis on Blood Pressure and Arterial Stiffness Indices

Start date: August 1, 2019
Phase: N/A
Study type: Interventional

Open label, randomized, cross-over clinical study comparing the acute effect of high versus low protein meals during dialysis on intradialytic blood pressure, 24-hour ambulatory blood pressure and arterial stiffness indices on maintenance hemodialysis patients.

NCT ID: NCT02934009 Terminated - Clinical trials for Hypotension During Dialysis

Dermal Profile Analysis Using the NMR-MOUSE

SHN
Start date: October 2016
Phase: N/A
Study type: Interventional

The determination of fluid status in dialysis patients is a major clinical problem. In this study the NMR-MOUSE is used to determine if it can be used to non-invasively determine hydration status of the skin. This evaluation will be performed in dialysis patients and healthy volunteers.

NCT ID: NCT01492634 Completed - Clinical trials for Hypotension During Dialysis

Optimizing Fluid Status

Start date: November 2011
Phase: N/A
Study type: Interventional

Title of study: Optimizing Fluid Status Study code: HD-IIT-01-E Study design: Prospective open design in study centre at two locations Applied medical device: Body Composition Monitor (BCM) for determination of fluid overload and dry weight Aim of the study: To improve the fluid status in chronic HD patients (measured as OH (overhydration) or TAFO (time averaged fluid overload)) based on BCM measurements. Up to now, the BCM was occasionally applied in both locations of the study centre. Study hypothesis: Regular measurement of fluid status (assessed by BCM) and display of dry weight (post-weight plan)will have significant consequences, namely a decrease of the: - time averaged fluid overload (TAFO), - proportion of patients with severe overhydration OH > 2.5 L,or OH/ECW > 15 %) - proportion of dehydrated patients (OH < -1.0 L, or OH < -7 %), - mean overhydration, - variance of overhydration, - time outside the reference range (-1.0L < OH < 2.5L). Devices used in this study: Dialysis machine 5008 equipped with Blood Pressure Monitor BPM, Blood Volume Monitor BVM, Blood Temperature Monitor BTM, and Online Clearance Monitor OCM ; Body Composition Monitor BCM ; Data management software / database system NephroLink Disposables used in this study: BVM blood lines and BCM electrodes Patients: 60 patients