Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis

NCT ID: NCT00004285

Last Updated: 2017-09-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1846 participants

Study Classification

INTERVENTIONAL

Study Start Date

1995-03-31

Study Completion Date

2001-12-31

Brief Summary

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OBJECTIVES: I. Evaluate whether hemodialysis providing a 2-pool, variable volume urea kinetic modelling value of 1.05 versus 1.45 reduces mortality and morbidity in patients with end stage renal disease.

II. Compare the efficacy of high versus low flux dialyzer membranes.

Detailed Description

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PROTOCOL OUTLINE: This is a randomized, multicenter study. Patients are stratified by center, age, and diabetes prior to dialysis initiation.

Patients are randomly assigned to 1 of 4 groups: moderate dose dialysis, low flux membrane; high dose dialysis, low flux membrane; moderate dose dialysis, high flux membrane; or high dose dialysis, high flux membrane. Moderate dose is a target eKt/V of 1.05 and high dose is 1.45. The dose and delivery of dialysis are measured monthly by the equilibrated fractional clearance of urea (eKt/V) calculated with double pool kinetics.

Patients are dialyzed 3 times a week in the shortest possible time (minimum 2.5 hours), adjusted for adequate fluid removal. General medical care, protein and calorie intake, and dialyzer reuse and other aspects of dialysis therapy are standardized. The protocol document lists approved dialyzers; no unsubstituted cellulosic membranes are permitted.

The intervention phase of this study is 5 years. Patients are followed for survival.

Conditions

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End Stage Renal Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard dose, low flux hemodialysis

Group Type ACTIVE_COMPARATOR

Standard dose, low flux hemodialysis

Intervention Type DEVICE

Standard dose, high flux hemodialysis

Group Type EXPERIMENTAL

Standard dose, high flux hemodialysis

Intervention Type DEVICE

High dose, low flux hemodialysis

Group Type EXPERIMENTAL

High dose, low flux hemodialysis

Intervention Type DEVICE

High dose, high flux hemodialysis

Group Type EXPERIMENTAL

High dose, high flux hemodialysis

Intervention Type DEVICE

Interventions

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Standard dose, low flux hemodialysis

Intervention Type DEVICE

Standard dose, high flux hemodialysis

Intervention Type DEVICE

High dose, low flux hemodialysis

Intervention Type DEVICE

High dose, high flux hemodialysis

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

PROTOCOL ENTRY CRITERIA:

--Disease Characteristics--

* End stage renal disease that requires in-center hemodialysis 3 times/week On hemodialysis for at least 3 months (6 months following renal transplant)
* No scheduled renal transplant from living donor

--Prior/Concurrent Therapy--

* No concurrent intervention studies unless ancillary to this protocol No concurrent investigational drugs

--Patient Characteristics--

* Hepatic: Albumin at least 2.6 g/dL by nephelometry No cirrhosis with encephalopathy or abnormal PT
* Renal: Urea clearance (interdialytic) no greater than 1.5 mL/min per 35 liters total urea volume
* Cardiovascular: No New York Heart Association class IV congestive heart failure despite maximal therapy No unstable angina No new onset angina No recent exacerbation of frequency, duration, or severity of angina
* Pulmonary: No chronic pulmonary disease requiring supplemental oxygen
* Other: Not hospitalized in acute or long term care facility at entry No active malignancy requiring chemotherapy or radiotherapy No AIDS No active systemic infection, e.g., tuberculosis or fungal infection No mental incompetence or other contraindication to protocol therapy Not pregnant Geographically available for treatment at participating institution No more than 20 missed treatments/year
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Rochester

OTHER

Sponsor Role collaborator

The Cleveland Clinic

OTHER

Sponsor Role collaborator

Tufts Medical Center

OTHER

Sponsor Role collaborator

Vanderbilt University

OTHER

Sponsor Role collaborator

Icahn School of Medicine at Mount Sinai

OTHER

Sponsor Role collaborator

Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

OTHER

Sponsor Role collaborator

Washington University School of Medicine

OTHER

Sponsor Role collaborator

University of Illinois at Chicago

OTHER

Sponsor Role collaborator

Main Line Health

OTHER

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role collaborator

Wake Forest University Health Sciences

OTHER

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Daniel B. Ornt

Role: STUDY_CHAIR

University of Rochester

Locations

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University of Rochester School of Medicine

Rochester, New York, United States

Site Status

Countries

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United States

References

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Greene T, Beck GJ, Gassman JJ, Gotch FA, Kusek JW, Levey AS, Levin NW, Schulman G, Eknoyan G. Design and statistical issues of the hemodialysis (HEMO) study. Control Clin Trials. 2000 Oct;21(5):502-25. doi: 10.1016/s0197-2456(00)00062-3.

Reference Type BACKGROUND
PMID: 11018567 (View on PubMed)

Eknoyan G, Beck GJ, Cheung AK, Daugirdas JT, Greene T, Kusek JW, Allon M, Bailey J, Delmez JA, Depner TA, Dwyer JT, Levey AS, Levin NW, Milford E, Ornt DB, Rocco MV, Schulman G, Schwab SJ, Teehan BP, Toto R; Hemodialysis (HEMO) Study Group. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med. 2002 Dec 19;347(25):2010-9. doi: 10.1056/NEJMoa021583.

Reference Type RESULT
PMID: 12490682 (View on PubMed)

Other Identifiers

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U01DK046109

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK046114

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK046126

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK046140

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK046143

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049240

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049241

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049242

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049243

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049244

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049249

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049252

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049254

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049259

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049261

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049264

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK049271

Identifier Type: NIH

Identifier Source: secondary_id

View Link

199/11704

Identifier Type: -

Identifier Source: org_study_id

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