Kidney Failure Clinical Trial
Official title:
A Controlled, Randomized Study to Assess the Quantitative Mass Transfer of Iron From SFP-containing Hemodialysate Under Varying Conditions of Blood and Dialysate Flow Rates, Dialyzer Membrane Types and Dialysate Bicarbonate Concentrations in CKD-HD Patients.
The purpose of this study is to determine the quantity of iron derived from SFP that is transferred from the dialysate to patients during a single dialysis session. The effects of various conditions which may affect the transfer of iron such as blood and dialysate flow rate, changes in bicarbonate delivery, dialyzer membrane type and the effect of reuse will also be investigated. The absorption and removal of iron from the blood will also be investigated.
- A total of 12 subjects on standard 3X/week hemodialysis will be studied in 2 groups (6
subjects per group)
- 2 primary dialyzer membranes will be studied.:
- Polyamide Membrane (Gambro Polyflux series: 17R and 21R)
- Cellulose Triacetate (Baxter CT series: CT-190)
- Each 1-week treatment cycle will include 3 haemodialysis (HD) sessions per subject,
including 2 study treatment-HD sessions and 1 non-treatment-HD session per subject.
Treatment-HD sessions will be conducted midweek and end-of-week (i.e. Dialysis days 3
and 5 of each week with a 1 day interdialytic interval) to avoid excessive fluid shifts
due to the increased UF needed during the non-treatment HD session (conducted at
beginning of the week; HD day 1).
- Within each group, each subject will be randomized to 1 of 6 treatment sequences. The
treatments to be investigated are: Control; new dialyzer, reused dialyzer, low blood
flow/dialysate flow, Low bicarbonate concentration and a different synthetic dialyzer
membrane (PAES)
- Blood for a complete serum iron profile over time will be obtained during the new
dialyzer (SFP/standard bicarbonate/new dialyzer/ high Qb and Qd) for all subjects. This
will necessitate approximately a 24-hour inpatient confinement to obtain blood at
specified time intervals after dialysis is completed. Blood for a partial iron profile
will be collected during the dialysis sessions at all other dialysis sessions.
- Each of the 6 enrolled subjects per dialyzer membrane type will be assigned to a
different sequence of treatments to help ensure that the treatment sequence does not
affect the analysis (Note: the first dialysis sessions of each of the 3 study weeks,
i.e. HD1, HD4 and HD7, are non-study related sessions during which no study procedures
are performed except for adverse event collection.
- Patients should not be receiving any of the following medications from screening
through the end of the study:
- Oral iron preparations, including multivitamin supplements containing iron
- Intravenous iron preparations
- Doses of ESA's should not be changed from screening to the end of the study.
;
Allocation: Randomized, Endpoint Classification: Bio-availability Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
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