Hemodialysis
Conditions
Keywords
Enhanced external counterpulsation, Hemodialysis, Arterial stiffness, Pulse wave velocity, Central aortic blood pressure
Brief summary
The objectives of this study are; * To study effect of Enhanced External Counter Pulsation on arterial stiffness, as measured by pulse wave velocity, compared to standard hemodialysis treatment. * To study effect of Enhanced External Counter Pulsation on central aortic blood pressure compared to standard hemodialysis treatment. * To study effect of Enhanced External Counter Pulsation on cardiac index decline during hemodialysis compared to standard hemodialysis treatment. * To study effect of Enhanced External Counter Pulsation on intradialytic hypotension events compared to standard hemodialysis treatment. * To study effect of Enhanced External Counter Pulsation on blood biomarkers for endothelial dysfunction and vascular inflammation compared to standard hemodialysis treatment. * To identify any adverse events from utilizing Enhanced External Counter Pulsation, such as pain or uncomfortable feeling, or even uncontrol hypertension.
Interventions
A device applying external pneumatic cuff pressure to the lower limbs, thighs, and buttock sequentially in the diastolic phase synchronouslty with electrocardiography to assist the cardiac function via diastolic augmentation mechanism.
Sponsors
Thana Thongsricome, MD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Dana analysis personnels are blinded to the reaserch arms. The subjects are not blinded to the treatment (not sham-controlled).
Intervention model description
Non sham-controlled, randomized study
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged 18 years old or older * Patients received hemodialysis at King Chulalongkorn Memorial Hospital for at least 3 months * Patients received hemodialysis frequency for at least 3 times/week with adequate hemodialysis, named single pool Kt/V of 1.2 or more, as calculated by Chula urea kinetic model * Patients achieving proper dry weight, as determined by clinical assessment or by body composition monitoring (Fresineus company)
Exclusion criteria
* Patients with severe or unstable disease required emergent specific treatment such as severe infection or hemodynamic instability * Patients with acute coronary syndrome within 1 month * Patients received coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty within 3 months * Patients with severe valvular heart disease and hypertrophic obstructive cardiomyopathy known before inclusion or detected by pre - allocation (within 12 months) echocardiographic assessment * Patients with cardiac arrhythmia including atrial fibrillation or atrial flutter known before inclusion or detected by pre - allocation (within 12 months) 12 - lead electrocardiography * Patients with known or suspected deep vein thrombosis or peripheral arterial disease * Patients with thoracic aortic aneurysm detected pre - allocation (within 12 months) echocardiography or abdominal aortic aneurysm detected by pre - allocation (within 12 months) abdominal ultrasonography * Patients with bleeding diathesis other than uremic bleeding, including anticoagulants use, but antiplatelets or local thrombolytics for vascular access stenosis/thrombosis are not included * Patients with uncontrolled hypertension, defined as systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg * Patients with severe pulmonary hypertension known before inclusion or detected by pre - allocation (within 12 months) echocardiographic assessment * Pregnant patients * Patients who not willing to give a consent or who cannot legally give a consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pulse wave velocity | Baseline, 1.5 months, and 3 months of research | Pulse wave velocity is a well-proven marker of arterial stiffness. |
Countries
Thailand
Outcome results
None listed