End stage renal disease Hemodialysis Vascular stiffness Cardiac ischemia End stage renal disease Hemodialysis Enhanced External Counter Pulsation (EECP) Arterial stiffness Pulse wave velocity
Conditions
Interventions
Standard hemodialysis therapy for 3 times per week accompanied by Enhanced External Counter Pulsation application for 1 hour per session in every hemodialysis session, within the first 3 hours of hemo
Experimental Device,No Intervention No treatment
Enhanced External Counter Pulsation (EECP) therapy,Control
Sponsors
Ratchadaphiseksompot reseach budget, faculty of medicine, Chulalongkorn university
The kidney foundation of Thailand
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients aged 18 years old or older 2. Patients received hemodialysis at King Chulalongkorn Memorial Hospital for at least 3 months 3. 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 4. Patients achieving proper dry weight, as determined by clinical assessment or by body composition monitoring (Fresineus company)
Exclusion criteria
Exclusion criteria: 1. Patients with severe or unstable disease required emergent specific treatment such as severe infection or hemodynamic instability 2. Patients with acute coronary syndrome within 1 month 3. Patients received coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty within 3 months 4. Patients with significant valvular heart disease and hypertrophic obstructive cardiomyopathy known before inclusion or detected by pre- allocation (within 12 months) echocardiographic assessment 5. Patients with cardiac arrhythmia including atrial fibrillation or atrial flutter known before inclusion or detected by pre -allocation (within 12 months) 12 leads electrocardiography 6. Patients with known or suspected deep vein thrombosis or peripheral arterial disease 7. 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 8. Patients with bleeding diathesis other than uremic bleeding, including anticoagulants use, but antiplatelets or local thrombolytics for vascular access stenosis/thrombosis are not included 9. Patients with uncontrolled hypertension, defined as systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg 10. Patients with severe pulmonary hypertension known before inclusion or detected by pre -allocation (within 12 months) echocardiographic assessment 11. Pregnant patients 12. Patients who not willing to give a consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Arterial stiffness 6 and 12 weeks Pulse wave velocity | — |
Secondary
| Measure | Time frame |
|---|---|
| Central aortic pressure 6 and 12 weeks Noninvasive pulse wave analysis,Cardiac index 1 weeks Dilutional methods via the vascular access,Vascular and cardiac biomarkers 3 months Serum troponin I, nitric oxide, endothelin 1 | — |
Countries
Thailand
Contacts
Public ContactThana Thongsricome
Faculty of Medicine, Chulalongkorn University
Outcome results
None listed