The Influences of Dialysate Bicarbonate Concentrations on Hemodialysis Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- End Stage Renal Disease on Dialysis
- Sponsor
- Camillians Saint Mary's Hospital Luodong
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Blood pressure during the hemodialysis
- Last Updated
- 6 years ago
Overview
Brief Summary
Background:
Patients with decreased kidney function are in the positive acid balance due to insufficient renal acid excretion. To correct the varying degrees of metabolic acidosis in these HD patients, a high concentration of HCO3 in the dialysate is routinely used.
During every 3-to-4 hours of HD treatment, a massive surge of HCO3 would enter the circulation and typically overcorrects predialysis acidosis to alkalosis and alkalemia.
The sharp acid-base shift can cause some adverse consequences.
The investigators believe that the rapid correction (or overcorrection) from the pre-dialysis metabolic acidosis to post-dialysis metabolic alkalosis during the 3-to-4 hours HD treatment would relate to adverse effects on HD patients.
Thus the investigators conduct this study to prove the hypothesis that "prevention of post-dialysis alkalosis by using lower dialysate HCO3 concentration might cause less adverse outcomes in ESRD patients on HD."
Study design:
Prospective cross-over case-control study.
Study population:
A total of 60 patients who receive regular hemodialysis (three times per week) for more than 6 months in the regional teaching hospital.
Investigators
Chih-Chung Shiao, MD
Director, Dept. of Medical Research and Education, Saint Mary's Hospital Luodong
Camillians Saint Mary's Hospital Luodong
Eligibility Criteria
Inclusion Criteria
- •adult uremic patients who received hemodialysis thrice weekly
Exclusion Criteria
- •Hospitalized patients
- •Patients newly initiated on HD (\<6 months)
- •Patients with HD access problems
- •Patients recently discharged from the hospital (within one month).
- •Patients on chemotherapy for cancer.
- •Patients with a kidney transplant.
- •Patients on steroids or other immunosuppressive therapy.
- •Patients with recent surgery (within one month)
- •Patients with an active bacterial infection.
- •Patients with decompensated cirrhosis.
Outcomes
Primary Outcomes
Blood pressure during the hemodialysis
Time Frame: four months
Blood pressure will be measured every 1 hour during the hemodialysis
O2 saturation during the hemodialysis
Time Frame: four months
O2 saturation will be measured every 1 hour during the hemodialysis
Respiratory rate during the hemodialysis
Time Frame: four months
Respiratory rate will be measured every 1 hour during the hemodialysis