Role of diastolic dysfunction in the pathogenesis of dialytic associated hypotension and effect of systematic colloid infusion in refractory cases

Completed

Conditions: End stage renal failure/hemodialysis patients/hemodynamic instability during dialysis sessions
Nutritional, Metabolic, Endocrine
Renal failure

Registration Number: ISRCTN20957055

Lead Sponsor: Association Quincy Recherche Clinique et Therapeutique (QRCT) (France)

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 116

Inclusion Criteria

1. Hemodialysis patients
2. Age > 16 years and < 90 years
3. Dialysis vintage <10 years
4. Treated by intermittent bipuncture bicarbonate hemodialysis 3 times per week
5. Dialysis hypotension-prone patients identified in the prospective cross-sectionnal study who were unresponsive to preventive measures

Exclusion Criteria

1. Left-ventricular ejection fraction < 40%
2. Malnutrition, anemia unresponsive to erythropoesis stimulating agents requiring transfusions, cancer or severe infection, inadequate dry weight assessed by echocardiography and echography of the vena cava inferior

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1. Cross-sectionnal study of hemodialysis patients: E/A ratio, Color M-mode diastolic flow propagation velocity (Vp)<br>2. Cross-over study of systematic infusion of colloids: arterial pressure regulation, i.e. Systolic Blood Pressure (SBP) and Diastolic Blood Pressure, and the number of hypotensive episodes (defined as SBP < 100 mmHg, regardless of symptoms)

Secondary Outcome Measures

Name	Time	Method
1. Cross-sectional study of hemodialysis patients :B-type natriuretic peptide (BNP), Cardiac index, Left-ventricular ejection fraction, Myocardial fractional shortening, Left ventricular mass index<br>2. Cross-over study of systematic infusion of colloids: nutritional status, ultrafiltration rate, dialysis quality microinflammatory status, oxidative stress, serum nitrate and nitrite levels