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Blood Pressure Slopes and Ultrafiltration in Hemodialysis Patients
Sponsor: VA Office of Research and Development
Summary
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.
Official title: Using Intradialytic Blood Pressure Slopes to Guide Ultrafiltration in Hemodialysis Patients
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
69
Start Date
2021-02-10
Completion Date
2026-07-01
Last Updated
2026-01-07
Healthy Volunteers
No
Interventions
IBPS-Guided Ultrafiltration
Each month, the study investigator will review the average intradialytic blood pressure slope from the prior two weeks. A prespecified algorithm will be used to prescribe additional fluid removal/weight reduction based on this slope.
Locations (1)
VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX
Dallas, Texas, United States