Blood Pressure Management in Hemodialysis Patients
Blood Pressure Slopes and Ultrafiltration in Hemodialysis Patients
Recruiting
N/AInterventional Study
End Stage Renal DiseaseHypertensionExtracellular Volume OverloadIntradialytic Hypotension
No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
18 and older
Sex
Any
Study type
Interventional
Purpose
Treatment
Participants needed
69 (estimated)
Sponsor
VA Office of Research and Development · Federal
Who this trial is looking for
This trial is looking for hemodialysis patients who have high blood pressure. Participants will have their blood pressure patterns monitored and compared to standard care to find better ways to manage blood pressure during treatment.
Are You a Good Fit for This Trial?
You may be able to join if
I am a hemodialysis patient.
My blood pressure before dialysis is greater than 140 mmHg on average over 2 weeks.
My blood pressure after dialysis is greater than 130 mmHg on average over 2 weeks.
You may not be able to join if
I have been on hemodialysis for less than 2 months.
I am pregnant.
My average blood pressure is below 95 mmHg during the screening period.
My average blood pressure before or after dialysis is greater than 180 mmHg.
I have a drop in blood pressure greater than 60 mmHg from before to after dialysis.
I regularly take clonidine during dialysis.
I regularly take midodrine during dialysis.
I do not follow my blood pressure medication plan.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer a few quick questions to see if you may meet the eligibility requirements.
Kidney failure has been recognized as one of the most costly chronic conditions among United States Veterans. Approximately 13,000 Veterans develop kidney failure each year, and most require hemodialysis initiation. Hemodialysis patients suffer significantly increased risk of death and hospitalizations, and excessive body fluid is a major cause of this. While empiric aggressive fluid removal durin…
Kidney failure has been recognized as one of the most costly chronic conditions among United States Veterans. Approximately 13,000 Veterans develop kidney failure each year, and most require hemodialysis initiation. Hemodialysis patients suffer significantly increased risk of death and hospitalizations, and excessive body fluid is a major cause of this. While empiric aggressive fluid removal during dialysis is one approach to limit fluid overload, this can cause dangerous decreases in blood pressure during dialysis that independently contribute to the high death rate. In this study, I aim to test a new strategy that prescribes fluid removal based on a patient's recent blood pressure patterns during dialysis. This clinical trial will compare my strategy to standard care and assess the outcomes of overall blood pressure change between dialysis treatments in addition to the number of times the blood pressure becomes dangerously low during dialysis. Another aim is to determine how differences in the structure and function of the heart influence blood pressure during dialysis.
Trial Locations
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Eligibility Criteria
Inclusion Criteria:
* Hemodialysis patient
* Pre-dialysis systolic blood pressure greater than 140 mmHg averaged over 2 weeks OR post-dialysis systolic blood pressure greater than 130 mmHg averaged over 2 weeks
Exclusion Criteria:
* HemoDialysis Vintage Less than 2 months
* Pregnancy
* Mean systo…
Inclusion Criteria:
* Hemodialysis patient
* Pre-dialysis systolic blood pressure greater than 140 mmHg averaged over 2 weeks OR post-dialysis systolic blood pressure greater than 130 mmHg averaged over 2 weeks
Exclusion Criteria:
* HemoDialysis Vintage Less than 2 months
* Pregnancy
* Mean systolic blood pressure nadir \<95 mmHg in 2 weeks screening
* Mean pre- or post-dialysis systolic blood pressure \>180 mmHg
* Mean pre to post-HD decrease in blood pressure \>60 mmHg
* Routine intradialytic clonidine use
* Routine intradialytic midodrine use
* Documented antihypertensive medication non-adherence
* Mean ultrafiltration rate \>13 mL/kg/hr during 2 week screening
* For bioimpedance measurements only: amputation of a major extremity, presence of cardiac defibrillator or pacemaker, presence of a metallic implant (prosthetic joint)
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