A Phase 4 interventional study of Furosemide and Chlorthalidone in End Stage Renal Disease on Dialysis, sponsored by University of Alberta. Terminated at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-08.
Sponsored by University of Alberta · Phase 4, Interventional, and Treatment
This pilot trial will evaluate the use of diuretic medications (furosemide and chlorthalidone) in participants on dialysis to see if these medications work to preserve existing kidney function, increase urine output, and reduce weight gain between dialysis treatments. Diuretics, which are sometimes called water pills, help the body to get rid of salt (sodium) and water. There are currently no guidelines for the use of diuretic medications in dialysis patients, including the type to use, or how much to use.
Fluid overload, or extracellular fluid volume expansion, in patients on hemodialysis is an important predictor of mortality. It is associated with hypertension and left ventricular hypertrophy - both risk factors for cardiovascular disease. In the United States, 80% of patients receiving hemodialysis have hypertension and 40% of patients on hemodialysis die from cardiovascular disease. The pathophysiology of hypertension in these patients is multifactorial, however, combined excess fluid and sodium is a key contributor.
While ultrafiltration (removal of fluid through dialysis) is important in managing fluid overload, fluid removed by hemodialysis is a non-physiological process which imposes hemodynamic stress on the cardiovascular system in uremic patients. This system is already maladaptive as a result of decreased baroreceptor sensitivity and increased vascular stiffness, leading to higher risk of hemodynamic instability when fluid is removed from the intravascular compartment. In patients who are anuric, restriction of fluid and sodium intake and ultrafiltration are the only options for volume control. In patients who continue to produce urine, however, optimizing the amount of urine produced could improve fluid overload and decrease cardiovascular stress.
Previous studies have shown that patients on hemodialysis who have residual renal function have better volume and sodium control. Higher residual renal function and higher urine output lead to a lower interdialytic weight gain in patients receiving hemodialysis; each of these factors have been associated with lower mortality. One intervention that may increase or help maintain residual renal function and increase urine output and therefore reduce interdialytic weight gain is diuretic therapy, which promotes the excretion of sodium and water by the native kidneys. Questions remain regarding the dose-response of the drug furosemide, about the utility of adding the drug chlorthalidone, and their clinical affects.
The main objective of this study is to determine the effects of starting, and escalating doses of diuretic medications (furosemide +/- chlorthalidone) on 24-hour urine output (volume) over a five-week period in patients on hemodialysis who produce >200cc per day of urine.
Secondary objectives are:
University of Alberta is the lead sponsor of 800 studies on the registry; 168 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Drug: Furosemide · Drug: Chlorthalidone
Each participant will have a 2 week period of no diuretic use followed by 3 weeks of escalating doses: 1) initially furosemide twice daily, then (2) an increased dose of furosemide twice daily, and in the final week, (3) the addition of chlorthalidone once daily.
Each participant will have a 2 week period of no diuretic use followed by 3 weeks of escalating doses: 1) initially furosemide twice daily, then (2) an increased dose of furosemide twice daily, and in the final week, (3) the addition of chlorthalidone once daily.
Change in 24-hour urine output
Change in urine output measured from 24-hour urine collection.
Time frame: Week 1
Change in 24-hour urine output
Change in urine output measured from 24-hour urine collection.
Time frame: Week 2
Change in 24-hour urine output
Change in urine output measured from 24-hour urine collection.
Time frame: Week 3
Change in 24-hour urine output
Change in urine output measured from 24-hour urine collection.
Time frame: Week 4
Change in 24-hour urine output
Change in urine output measured from 24-hour urine collection.
Time frame: Week 5
Change in residual renal function
Calculated based on weekly bloodwork (urea and creatinine levels) and 24-hour urine collection.
Time frame: Week 1
Change in residual renal function
Calculated based on weekly bloodwork (urea and creatinine levels) and 24-hour urine collection.
Time frame: Week 2
Change in residual renal function
Calculated based on weekly bloodwork (urea and creatinine levels) and 24-hour urine collection.
Time frame: Week 3
Change in residual renal function
Calculated based on weekly bloodwork (urea and creatinine levels) and 24-hour urine collection.
Time frame: Week 4
Change in residual renal function
Calculated based on weekly bloodwork (urea and creatinine levels) and 24-hour urine collection.
Time frame: Week 5
Interdialytic weight gain
Patient weight measured in kilograms
Time frame: Week 1
Interdialytic weight gain
Patient weight measured in kilograms
Time frame: Week 2
Interdialytic weight gain
Patient weight measured in kilograms
Time frame: Week 3
Interdialytic weight gain
Patient weight measured in kilograms
Time frame: Week 4
Interdialytic weight gain
Patient weight measured in kilograms
Time frame: Week 5
Patient-reported outcomes - ESAS-r
Patient reported outcomes using the Edmonton Symptom Assessment System-revised (ESAS-r) questionnaire.
Time frame: Week 1
Patient-reported outcomes - ESAS-r
Patient reported outcomes using the Edmonton Symptom Assessment System-revised (ESAS-r) questionnaire.
Time frame: Week 2
Patient-reported outcomes - ESAS-r
Patient reported outcomes using the Edmonton Symptom Assessment System-revised (ESAS-r) questionnaire.
Time frame: Week 3
Patient-reported outcomes - ESAS-r
Patient reported outcomes using the Edmonton Symptom Assessment System-revised (ESAS-r) questionnaire.
Time frame: Week 4
Patient-reported outcomes - ESAS-r
Patient reported outcomes using the Edmonton Symptom Assessment System-revised (ESAS-r) questionnaire.
Time frame: Week 5
Patient-reported outcomes - Muscle cramps
Patient reported outcomes using a muscle cramps question.
Time frame: Week 1
Patient-reported outcomes - Muscle cramps
Patient reported outcomes using a muscle cramps question.
Time frame: Week 2
Patient-reported outcomes - Muscle cramps
Patient reported outcomes using a muscle cramps question.
Time frame: Week 3
Patient-reported outcomes - Muscle cramps
Patient reported outcomes using a muscle cramps question.
Time frame: Week 4
Patient-reported outcomes - Muscle cramps
Patient reported outcomes using a muscle cramps question.
Time frame: Week 5
Adverse effects
Adverse effects based on symptoms and weekly bloodwork.
Time frame: Week 1
Adverse effects
Adverse effects based on symptoms and weekly bloodwork.
Time frame: Week 2
Adverse effects
Adverse effects based on symptoms and weekly bloodwork.
Time frame: Week 3
Adverse effects
Adverse effects based on symptoms and weekly bloodwork.
Time frame: Week 4
Adverse effects
Adverse effects based on symptoms and weekly bloodwork.
Time frame: Week 5
Urine furosemide levels
Urine furosemide levels from weekly urine samples
Time frame: Week 3
Urine furosemide levels
Urine furosemide levels from weekly urine samples
Time frame: Week 4
Urine furosemide levels
Urine furosemide levels from weekly urine samples
Time frame: Week 5
Plan to share: No
No publications or documents are linked to this record.
This study is terminated, as verified in May 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
University of Alberta