Acid-Base Balance Disorder, Phosphorus Metabolism Disorders
Conditions
Keywords
phosphorus, hemodialysis, bicarbonate, acidosis, alkalosis
Brief summary
Hyperphosphatemia is still an unresolved problem among hemodialysis patients and significantly increases the risk of death from cardiovascular diseases. Research to date has not answered the question of whether dialysate bicarbonate concentration profiling can improve phosphate removal and its concentration without negative impact on the acid-base balance. This study addressed this issue. Twenty stable hemodialysis patients will enroll to a four-week study during which different dialysate bicarbonate concentration profiles will be used each week. Each patient will undergo the following profiles (one-week periods): Treatment A - stable dialysate bicarbonate concentration Dbic 35 mmol/L during the whole HD session, Treatment B - Dbic 35 mmol/L for the first two hours and Dbic 30 mmol/L for the next two hours and Treatment C - the opposite mid-HD change Dbic from 30 to 35 mmol/L and one week wash-out period between Treatment B and C. We will collect blood samples each hour during the session and one hour after HD completion.
Interventions
OTHERGroup 1: B) Dbic 35 -30 mmol/L C) Dbic 30- 35 mmol/L
A change Dbic in a middle of hemodialysis
OTHERGroup 2: C) Dbic 30 -35 mmol/L B) Dbic 35- 30 mmol/L
A change Dbic in a middle of hemodialysis
Sponsors
University of Warsaw
Polish Academy of Sciences
Medical University of Warsaw
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Blood acid-base and uremic solute levels were measured in twenty chronic HD patients during 4-hour treatments with A) constant Dbic of 35 mmol/L; B) Dbic of 35 mmol/L for the first two hours and 30 mmol/L for the second two hours; and C) Dbic of 30 mmol/L for the first 2 hours and 35 mmol/L later. Treatment interventions were fixed during a given week, arterial blood samples were obtained predialysis and every hour during the treatment, during the second and third treatments of the week.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* stable general condition * hemodialysis more than 3 months * Dialysis 3 times a week/ 4 hours +/- 20 minutes * Dialysis with arterio-venous fistulas * bicarbonate titer before hemodialysis 22-24 mmol/l
Exclusion criteria
* diabetes mellitus * cachexia * inflamation processes * usage of sevelamer last month * utrafiltration during dialysis more than 2500 ml
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The blood phosphorus concentration change in hemodialysis patient | 4 weeks | The blood phosphorus concentration change in hemodialysis patient using dialysate bicarbonate profiling |
Secondary
| Measure | Time frame |
|---|---|
| The maintaining the acid-base balance in accordance with applicable recommendations. | 4 weeks |
Countries
Poland
Outcome results
None listed