End Stage Renal Disease on Dialysis
Conditions
Keywords
metabolic acidosis, sodium bicarbonate, hemodialysis, dialysate
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.
Interventions
PROCEDUREConcentration of dialysate bicarbonate
Adjust the dialysate bicarbonate concentration
Sponsors
Camillians Saint Mary's Hospital Luodong
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Blood pressure during the hemodialysis | four months | Blood pressure will be measured every 1 hour during the hemodialysis |
| Respiratory rate during the hemodialysis | four months | Respiratory rate will be measured every 1 hour during the hemodialysis |
| O2 saturation during the hemodialysis | four months | O2 saturation will be measured every 1 hour during the hemodialysis |
Countries
Taiwan
Contacts
Primary ContactChih-Chung Shiao, MD
Outcome results
None listed