Clinical Research Directory

Experience of Young Adult Kidney Patients Requiring Haemodialysis

This study has been designed with individuals with lived experience of kidney disease and is a mixed methods study. The aim is to explore experiences of young adults (16-30) receiving haemodialysis in a centre or in a hospital, to understand barriers to opportunities for social interaction and to develop co-produced resources to address social isolation in the dialysis setting. This aim of this study is to give a voice to young adults who are receiving haemodialysis in a centre or hospital setting. There will be 3 parts to this study: 1. What is the support for young adults on haemodialysis. A survey will be sent out to all of the haemodialysis units to find out about support for young adults. Young adults who have had haemodialysis in a unit will be asked about their experiences. We will ask if they feel lonely or social isolated. 2. To explore the experiences of young adults on haemodialysis. We will have focus groups and interviews with young adults and ask them about experiencing haemodialysis in a unit. Young adults from diverse backgrounds will be recruited. This is to make sure that the recommendations and resources are meeting the needs of all young adults. 3. Develop recommendation and resources for young adults on haemodialysis. A workshop with young adults and individuals with experience of haemodialysis. Will be held. Resources and recommendations, for improving the experience of young adults on haemodialysis will be developed. Interventions for implementing will be discussed as well. This will be a face-to-face workshop but with if useful people can attend virtually. This study is an opportunity to help change or improve young adults experience in the future. Having haemodialysis as a young adult shouldn't make a person feel lonely or isolated.

Expanded Hemodialysis Versus High-Volume Online Hemodiafiltration for Uremic Toxin Removal

People with advanced kidney disease need dialysis to remove waste products from the blood. Some of these waste products, called uremic toxins, are small, while others are medium-sized and more difficult to remove. Poor removal of these toxins may contribute to symptoms and long-term complications in patients on dialysis. Two dialysis techniques are commonly used to improve toxin removal beyond standard hemodialysis: expanded hemodialysis (HDx) using medium cut-off membranes, and high-volume online hemodiafiltration (HV-OL-HDF). Although both techniques are effective, the best way to prescribe expanded hemodialysis-particularly the ideal treatment time-has not been clearly defined. The purpose of this study is to compare how well different treatment times of expanded hemodialysis remove small and medium-sized uremic toxins, and to compare these results with high-volume online hemodiafiltration. Toxin removal will be evaluated using a combined measurement called the Global Removal Score, which summarizes the removal of several important waste substances. This is a single-center, randomized, open-label, crossover study. Adults receiving maintenance hemodialysis will receive three different expanded hemodialysis sessions with different treatment durations (180, 210, and 240 minutes), followed by one session of high-volume online hemodiafiltration. Blood samples will be taken before and after each dialysis session to measure toxin levels. The results of this study may help determine whether expanded hemodialysis with shorter or standard treatment times can achieve toxin removal similar to high-volume hemodiafiltration, which could support more personalized and practical dialysis prescriptions.

Outcomes of Renal Replacement in Mexico

A descriptive, observational, prospective, multicenter study aimed at describing the main clinical outcomes of patients with chronic kidney disease receiving any form of renal replacement therapy in Mexico.

Restorative and Supportive Meals at HomeCare

The pilot intervention study is designed to evaluate the feasibility of implementing a tailored medical nutrition therapy (MNT) meal-delivery for 25 elderly, low-income food insecure patients with end-stage kidney disease undergoing maintenance hemodialysis at dialysis centers. Following comprehensive baseline assessments, participants will first maintain their usual dietary patterns for a 4-week control period to establish baseline nutritional and clinical parameters. This will be followed by a 4-week intervention period during which participants will receive individually tailored MNT meals designed to meet their renal-specific nutritional requirements, including energy, protein, potassium, phosphate and sodium intake. Weekly monitoring during dialysis sessions will include assessment of adherence, dietary intake, and clinical tolerance, providing detailed insights into the feasibility, safety, and potential clinical impact of the tailored nutrition intervention in this vulnerable population.

the Cardioprotective Effects of Improving Potassium Variability in Maintenance Hemodialysis Patients

The management of serum potassium in maintenance hemodialysis（MHD ）patients is one of the hot topics at present. In order to control hyperkalemia in dialysis patients, the use of hypokalemic dialysate is the most important measure to reduce potassium. This measure effectively reduces serum potassium, but increases the risk of hypokalemia after dialysis, which increases the risk of all-cause death in patients. Hyperkalemia and hypokalemia during and at the end of dialysis are important factors for arrhythmia and death in MHD patients. Due to the intermittent nature of hemodialysis treatment, MHD patients often experience frequent fluctuations in serum potassium, which is a potential risk factor for poor prognosis of MHD patients. Serum potassium variability can better reflect the potassium homeostasis in MHD patients. In addition to hyperkalemia and hypokalemia, serum potassium variability is a potential risk factor affecting the prognosis of MHD patients. At present, there are few studies on the effect of improving serum potassium variability on cardiovascular complications, especially multi-center randomized controlled trials. In this study, sodium zirconium cyclosilicate was used to control hyperkalemia before dialysis and increase potassium concentration in dialysate, so as to reduce the risk of hypokalemia after dialysis, and to verify whether improving serum potassium variability can reduce myocardial injury in hemodialysis patients.

Arteriovenous Fistula Cannulation Pain and Skin Cooling Device

To determine the effect of the antistress ball, valsalva maneuver and skin cooling device, which are one of the nonpharmacological methods applied to hemodialysis patients, on the level of pain and fear of pain due to arteriovenous fistula cannulation.