Rising the temperature and reducing the flow rate of fluid meant for exchange of waste products from blood in hemo ( blood ) dialysis and its impact on removal of waste products in end stage kidney disease patients - a strategy for conservation of water

Phase 2

Completed

Conditions: End stage renal disease,

Registration Number: CTRI/2022/01/039108

Lead Sponsor: Director Institute of Nephrology Madras Medical College

Brief Summary: This study aims to find out the impact on solute clearance and ability to achieve adequate dialysis by increasing the dialysate temperature from 37 to 38.5 degree centigrade and reducing dialysate flow from 500 ml to 300 ml per minute - as a strategy for conservation of water in hemodialysis. End stage kidney disease patients who are on hemodialysis for more than three months and of age between 18 and 65 years with good functioning arterio venous fistula , with no evidence of recurrent intradialytic hypotension and left ventricular ejection fraction more than 40 % will be included. Those who are on tunneled or non tunneled catheter as access , who had recurrent intradialytic hypotension, those with autonomic neuropathy and left ventricle ejection fraction less than 40 % will be excluded. This is a non randomised single arm open labelled cross over trial. A sample of 30 patients will be given dialysis with a dialysate temperature of 37 degree and flow of 500 ml per minute for first month followed by same set of patients subjected to the intervention of increasing the dialysate temperature to 38.5 degree and reducing the flow to 300 ml per minute. Primary outcome will be calculation of urea reduction ratio and time to achieve online Kt/V of 1.2 at the end of each dialysis session for total of 8 to 12 session during the control period and intervention period. secondary outcome is recording the number of episodes of intradialytic hypotension during both the period.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 30

Inclusion Criteria

1.Patients with well functioning AVFistula.
2.Dialysis vintage more than 3 months.
3.No previous episodes of recurrent intradialytic hypotension.

Exclusion Criteria

1.Patients with tunneled or non tunneled catheters as the dialysis access.
2.Patients with recurrent intradialytic hypotension.
3.Patients with autonomic neuropathy.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1.Urea reduction ratio in every session of hemodialysis.	one month each for intervention and comparator arm that includes 8 to 12 session of hemodialysis
2. calculation of online Kt/V and time to reach the target of 1.2 in every session of dialysis.	one month each for intervention and comparator arm that includes 8 to 12 session of hemodialysis

Secondary Outcome Measures

Name	Time	Method
1. number of episodes of intradialytic hypotension	one month each for intervention and comparator arm that includes 8 to 12 session of hemodialysis

Trial Locations

Locations (1): Madras Medical College
🇮🇳
Chennai, TAMIL NADU, India
Madras Medical College
🇮🇳Chennai, TAMIL NADU, India
Dr Sakthirajan R
Principal investigator
09444126080
draatral@gmail.com