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CompletedNCT03397992Updated Jan 12, 2018

Low Dialysate Temperature During SLED

An interventional study of Changing dialysate temperature in Acute Kidney Injury and Intra-dialytic Hypotension, sponsored by Washington University School of Medicine. Completed. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-01-12.

Sponsored by Washington University School of Medicine · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
38
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Objectives: This study is evaluating the hemodynamic effects of lowering the dialysate temperature in acute kidney injury (AKI) patients submitted to sustained low efficiency dialysis (SLED) in a single large center.

Methods: Participants will be randomly assigned to two treatment groups. One group will be started treatment with low temperature (set point 5 on the machine which is around 35°C) for one treatment and then alternate between high and low temperatures for a maximum of 8 treatments. The other group will be started with high temperature (set point 9 on the machine which is around 37°C) for the first treatment then alternate between high and low temperatures for a maximum of 8 treatments. Each participants will need at least two treatments, one with each temperature to be included in the analysis. The investigators will be looking for the number of events during a SLED treatment. Events will be defined as drop in systolic blood pressure ≥ 20 mmHg or drop in mean arterial pressure (MAP) of ≥10 mmHg, requirement of resuscitation with IVF after initiation of SLED, initiation or increase requirement of vasoactive drugs.

02

Conditions studied

  • Acute Kidney Injury
  • Intra-dialytic Hypotension
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18 years of age or older, AKI stage 3 requiring RRT, maximum two pressers, initial temperature of 36°C or higher.

Exclusion criteria

Exclusion Criteria:

  • Initial temperature less than 36°C, ESRD, three or more pressers, requirement of antihypertensive medications.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Care provider)
Enrollment
38 participants (actual)

Study arms

  • Active comparator
    Group A

    Treatment with high dialysate temperature first followed by low dialysate temperature and alternating thereafter.

    Other: Changing dialysate temperature

  • Active comparator
    Group B

    Treatment with low dialysate temperature first followed by high dialysate temperature and alternating thereafter

    Other: Changing dialysate temperature

Interventions

  • OtherChanging dialysate temperature

    Patients had SLED with low dialysate temperature (around 35°C) compared with high dialysate temperature (around 37°C)

05

What researchers measure

Primary outcomes

  1. Number of intradialytic hypotension episodes with different dialysate temperatures

    Hypothesis is that low dialysate temperature will decrease the number of hypotensive episodes during SLED treatment, hypotensive episodes are defined as drop in SBP ≥ 20 mm Hg or MAP ≥ 10 mm Hg, decrease in ultrafiltration rate, increase or start of vasoactive agents or termination of treatment because of hypotension.

    Time frame: Participants who are enrolled are monitored during SLED treatment which can run from 8 to 14 hours for maximum of 8 treatments or till participant is switched to a different dialysis modality

Secondary outcomes

  1. Effect on baseline body temperature

    Change of body temperature during and at end of SLED treatment from baseline temperature measured before starting SLED

    Time frame: Participants who are enrolled are monitored during SLED treatment which can run from 8 to 14 hours for maximum of 8 treatments or till participant is switched to a different dialysis modality

  2. Effect on total ultrafiltration

    The total amount of fluid ordered to be removed will be compared with the amount actually removed

    Time frame: Participants who are enrolled are monitored during SLED treatment which can run from 8 to 14 hours for maximum of 8 treatments or till participant is switched to a different dialysis modality

  3. Effect on Kt/V

    The dialysis dose will be monitored

    Time frame: Participants who are enrolled are monitored during SLED treatment which can run from 8 to 14 hours for maximum of 8 treatments or till participant is switched to a different dialysis modality

06

Study locations

No study locations are listed for this record.

07

References and documents

Publications

  • Edrees FY, Katari S, Baty JD, Vijayan A. A Pilot Study Evaluating the Effect of Cooler Dialysate Temperature on Hemodynamic Stability During Prolonged Intermittent Renal Replacement Therapy in Acute Kidney Injury. Crit Care Med. 2019 Feb;47(2):e74-e80. doi: 10.1097/CCM.0000000000003508. PubMed 30394919 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03397992
Lead sponsor
Washington University School of Medicine
Responsible party
Fahad Edrees (Principal Investigator, Washington University School of Medicine) — Principal investigator
First posted
Jan 12, 2018
Start date
Jan 16, 2017
Primary completion
Apr 22, 2017
Completion
Apr 22, 2017
Last update
Jan 12, 2018

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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