Mechanisms of Intradialytic Hypertension
- Conditions
- Renal Failure Chronic Requiring HemodialysisHaemodialysis-induced SymptomHypertension
- Registration Number
- NCT01947673
- Lead Sponsor
- Emory University
- Brief Summary
Patients with end-stage renal disease (ESRD) are at significantly higher risk for death due to cardiovascular disease. Those with paradoxical increases in blood pressure (BP) during hemodialysis (HD), defined as intradialytic hypertension (IDH), are at even greater risk of cardiovascular mortality. This study seeks to determine the mechanisms that underlie IDH, and whether mindfulness meditation might improve BP during dialysis in these patients. The investigators will first determine if increased adrenaline levels during volume removal contributes to IDH. The investigators will then determine lack of suppression of adrenaline levels in the setting of a high BP also contributes to IDH. This will be done by manipulating blood pressure by using small amounts of vasoactive drugs, and determining if an appropriate response in adrenaline levels occurs. Lastly, the investigators will determine if an intradialytic mindfulness meditation program improves BP and adrenaline levels in ESRD patients with IDH.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 49
- ESRD patients on maintenance hemodialysis for at least 6 months, with increased blood pressure during hemodialysis
- drug or alcohol abuse
- any serious systemic disease that might influence survival
- severe anemia with hgb level <8 g/dL
- clinical evidence of congestive heart failure
- ejection fraction below 35%
- myocardial infarction or cerebrovascular accident within the past six months
- symptomatic heart disease determined by electrocardiogram, stress test, and/or history
- treatment with central alpha agonists or monoamine oxidase (MAO) inhibitors
- peripheral neuropathy
- autonomic dysfunction
- pregnancy
- surgery within the past 3 months
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Cardiopulmonary baroreflex Sensitivity 8 weeks Blood Pressure during dialysis 8 weeks
- Secondary Outcome Measures
Name Time Method Kidney Disease Quality of Life (KDQOL) Symptom Score 8 weeks
Related Research Topics
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Trial Locations
- Locations (1)
Emory Dialysis Clinics
🇺🇸Atlanta, Georgia, United States
Emory Dialysis Clinics🇺🇸Atlanta, Georgia, United States