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Trial registered on ANZCTR
Registration number
ACTRN12618000988257
Ethics application status
Not required
Date submitted
7/06/2018
Date registered
13/06/2018
Date last updated
22/10/2021
Date data sharing statement initially provided
15/05/2019
Date results provided
22/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Assessment of Intradialytic Hypertension Management in Adults
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Scientific title
Observational study of individualised dialysate sodium in adult haemodialysis patients and its effect on the occurrence of intradialytic hypertension
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Secondary ID [1]
295134
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Nil Known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hypertension
308228
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Haemodialysis
308230
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Condition category
Condition code
Renal and Urogenital
307256
307256
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0
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Kidney disease
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Cardiovascular
307257
307257
0
0
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Hypertension
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Adjustment of dialysate sodium concentration during haemodialysis within the range 135 to 145mmol/L to achieve net zero diffusive sodium flux as part of standard local clinical practice in patients receiving haemodialysis that experience intradialytic hypertension. The sodium flux will be determined by simultaneous sampling of pre and post dialyser blood, with pre and post dialyser dialysate sampling for confirmation. The initial dialysate sodium will be set at 140mmol/L and then adjusted iteratively at 3 consecutive dialysis sessions then continued indefinitely at that concentration. Patients will be observed for 2 months following the assessment of dialysate sodium flux, whether or not this assessment results in a change in dialysate sodium.
Adjustment will be according to the formula
New dialysate sodium = [Current dialysate Na] + ([Na]arterial - [Na]venous)
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Intervention code [1]
301461
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
306208
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Presence of intradialytic hypertension. This will be assessed by query of the electronic medical record 2 months after patients undergo assessment of dialysate sodium flux, whether or not this assessment has resulted in a change in the dialysate sodium concentration.
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Assessment method [1]
306208
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Timepoint [1]
306208
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Two months after the assessment of dialysate sodium flux, whether or not this assessment has resulted in a change in dialysate sodium.
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Secondary outcome [1]
347880
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Thirst by use of a Likert scale administered prior to assessment of dialysate sodium flux and again 1 month later.
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Assessment method [1]
347880
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Timepoint [1]
347880
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1 month after assessment of dialysate sodium flux
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Eligibility
Key inclusion criteria
Patients with a median rise in BP of > 10 mmHg during dialysis over the preceding 2 week period AND an average pre-dialysis systolic BP >115 mmHg.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with an average pre-dialysis systolic BP <=115 mmHg over the preceding 2 weeks.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Descriptive statistics (relative frequency of intradialytic hypertension in patients before and after alteration of their dialysate sodium).
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data analysis is complete
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
Treatment did not appear to have any effect on intradialytic hypertension so intervention was no longer offered to patients.
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Date of first participant enrolment
Anticipated
18/06/2018
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Actual
27/08/2018
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Date of last participant enrolment
Anticipated
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Actual
1/01/2019
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Date of last data collection
Anticipated
23/05/2019
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Actual
17/05/2019
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Sample size
Target
15
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Accrual to date
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Final
8
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Recruitment in Australia
Recruitment state(s)
ACT
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Recruitment hospital [1]
11106
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The Canberra Hospital - Garran
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Recruitment postcode(s) [1]
22919
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2605 - Garran
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Funding & Sponsors
Funding source category [1]
299726
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Hospital
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Name [1]
299726
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The Canberra Hospital
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Address [1]
299726
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77 Yamba Drive
Garran, ACT, 2605
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Country [1]
299726
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Australia
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Primary sponsor type
Individual
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Name
Richard Singer
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Address
Renal Unit
The Canberra Hospital
PO Box 11
ACT 2606
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Country
Australia
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Secondary sponsor category [1]
299060
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None
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Name [1]
299060
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Address [1]
299060
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Country [1]
299060
0
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Ethics approval
Ethics application status
Not required
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Summary
Brief summary
A rise in systolic blood pressure at the end of dialysis treatment compared to the beginning is associated with increased mortality during follow-up. This observational study aimed to see whether adjusting the dialysate sodium such that it matched the patient sodium helped to prevent significant rises in blood pressure during treatment, without causing undesirable falls in blood pressure. Matching of patient and dialysate sodium will be accomplished by adjusting the dialysate sodium so that the blood sodium concentration leaving the patient to go through the dialyser is the same as that re-entering the patient after its passage through the dialyser. Our hypothesis is that individualising the dialysate sodium in this way will reduce blood pressure problems during the dialysis treatment and may improve thirst.
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Trial website
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Trial related presentations / publications
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Public notes
This observational study was assessed by the ACT Health Ethics Committee and determined to be a QA project that did not require ethics approval. Reference was ETHLR.18.005
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Contacts
Principal investigator
Name
84222
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Dr Richard Singer
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Address
84222
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Renal Unit
The Canberra Hospital
PO Box 11
Woden, ACT 2606
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Country
84222
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Australia
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Phone
84222
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+61262442222
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Fax
84222
0
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Email
84222
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[email protected]
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Contact person for public queries
Name
84223
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Richard Singer
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Address
84223
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Renal Unit
The Canberra Hospital
PO Box 11
Woden, ACT 2606
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Country
84223
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Australia
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Phone
84223
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+61262442222
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Fax
84223
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Email
84223
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[email protected]
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Contact person for scientific queries
Name
84224
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Richard Singer
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Address
84224
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Renal Unit
The Canberra Hospital
PO Box 11
Woden, ACT 2606
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Country
84224
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Australia
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Phone
84224
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+61262442222
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Fax
84224
0
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Email
84224
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Do not have permission for this from the applicable ethics committee
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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