Intradialytic Hypotension
Conditions
Keywords
Auto-moxibusition, intra-dialytic hypotension, hemodialysis
Brief summary
Intradialytic hypotension (IDH) is a most frequent complication of hemodialysis (HD) and may contribute to cardiovascular events and high mortality. The etiology of IDH is multifactorial; therefore, it remains a challenging problem in the management of HD patients. Because moxibustion (MO) at specific points can influences hemodynamics, we hypothesize that Tianjiu (auto-MO) at the traditionally used meridian points will reduce the severity of hypotension in patients who undergo HD.
Detailed description
In this clinical trial, 45 patients had IDH were divided randomly into two (auto-MO therapy and control) groups for 4 weeks. In the Tianjiu (auto-MO) group, the patients were applied at 3 points (Conception Vessel 4, and Kidney 1) for 3-4 h during HD sessions. All number of episodes complicated by symptomatic IDH during HD sessions and the number of IDH-related nursing interventions (Trendelenburg position, manual reduction of ultrafiltration rate, infusion of isotonic saline or hypertonic fluid, lowering of dialysate temperature) in a session were recorded. Pre- and post-dialysis systolic and diastolic BP, pre- and post-dialysis body weights, interdialytic weight gain, percentage of target ultrafiltration achieved, patient's subjective assessment of the degree of fatigue after dialysis (scale from 0 to 10; 0, not at all, 10, extremely) and recovery time from fatigue after dialysis were measured at the 0, 2nd, 4th and 6th week.
Interventions
OTHERTianjiu
After randomization, patients in Tianjiu and placebo (non-Tianjiu) groups will receive 12 sessions of treatment over a 4-week treatment period.The format of the Tianjiu intervention will be the same as in the treatment group. Participants will be instructed to lie supine before their HD session, and then the bilateral KI1 and CV4
OTHERPlacebo (non-Tianjiu)
The format of the placebo (clay) intervention will be the same as in the treatment group.
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* The subjects enrolled in the study were patients undergo regular hemodialysis, ranging from 20-75 years of age, at nephrologic clinic in KCGMH. These patients have experienced \> 3 episodes of intradialytic hypotension in recent two months.
Exclusion criteria
* (1)confounding diseases such as sepsis, cancer, decompensated liver cirrhosis, respiratory failure, and heart failure(NYHA\>3), (2) disturbed consciousness, (3) pregnancy, (4) can't tolerate the heat and allergy to automoxibustion,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The % of target ultrafiltration achieved | 1 year | The actual ultrafiltration volume divided by the target ultrafiltration volume |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The frequency of IDH episodes and number of nursing interventions during HD sessions | 1 year | The number of IDH record and related nursing intervention during each H/D session |
| patient's participative assessment of the degree of fatigue after dialysis (scale from 0-10) | 1 year | The improvement of subjective symptom |
| Patients' recovery time from fatigue after dialysis | 1 year | Recovery time is recorded within minutes, when arriving home, at bed time, the next morning, by next HD |
Countries
Taiwan
Contacts
Primary ContactMing-Yen Tsai, MS
Outcome results
None listed