What happens to phosphorus levels during hemodialysis?

Not yet recruiting

Conditions: End stage renal disease,

Registration Number: CTRI/2019/05/019383

Lead Sponsor: Dr Namrata Rao S

Brief Summary: Hyperphosphatemiain endstage renal disease patients has been associated with greater risk ofmortality, especially due to cardiovascular causes (1). Most commonly,nephrologists employ an approach of dietary phosphorus restriction, use ofphosphate binders and hemodialysis, to facilitate maintenance of serumphosphate levels in dialysis patients. A majority of Indian dialysis patientsreceive two/week hemodialysis sessions, as against three/week in the Westernworld. Indian diet is vastly different from typical Western diet and variousregional differences exist too. Dietary modifications to increase protein and minimizephosphorus intake, are only variably successful, as cost and logistics play greaterrole in deciding the patientâ€™s diet, rather than the clinicianâ€™s advice (1).Therefore, the onus of phosphate removal falls upon a combination of phosphatebinders and the hemodialysis sessions.

**Briefreview**: Regardingdialytic phosphorus removal, available literature is unclear whether short,frequent hemodialysis sessions are more beneficial than prolonged sessions inreducing serum phosphorus levels (2,3). To our knowledge, only a single study hasevaluated dialytic phosphorus removal over a period of time (4). This studyfound out that while the first hour of hemodialysis normalizes serum phosphoruslevels, significant amount of phosphorus continues to be removed in thesubsequent hours as well. The present study will observe dialysis phosphorusremoval at hourly intervals and help in deciding which approach will tackle hyperphosphatemia effectively â€“ increasing dialysis duration orfrequency. Moreover, no other study has undertaken the evaluation of dietaryphosphorus intake and dialytic phosphorus removal in an Indian populationbefore.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 40

Inclusion Criteria

Patient of endstage renal disease on maintenance hemodialysis for > 3 months No hospitalizations in the last 3 months Written, informed consent.

Exclusion Criteria

Need for hospitalization in the last 3 months Inability to record diet and drug history Hemodialysis sessions requiring blood transfusion Missed session of hemodialysis in the preceding week.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To prospectively evaluate phosphate removal by hemodialysis in patients with endstage renal disease in a tertiary care hospital in northern India	0,1,2,3,4,5 hours after onset of dialysis

Secondary Outcome Measures

Name	Time	Method

Trial Locations

Locations (1): Dr. Ram Manohar Lohia Institute of Medical Sciences
🇮🇳
Lucknow, UTTAR PRADESH, India
Dr. Ram Manohar Lohia Institute of Medical Sciences
🇮🇳Lucknow, UTTAR PRADESH, India
Dr Namrata Rao
Principal investigator
09454360872
snamratarao@yahoo.co.in