Calcium Mass Balance and Dialytic Efficiency of a New cITRate-containing and Acetate-free Dialysis flUidS: CITRUS Study

NCT ID: NCT02848937

Last Updated: 2016-07-29

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

UNKNOWN

Total Enrollment

62 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-03-31

Study Completion Date

2016-12-31

Brief Summary

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This study aimed to evaluate the effect on the calcium balance of a concentrate with 1 mM citrate and locate the equivalent concentration of calcium (Ca\_eq) at a concentration of 3 mM acetate and traditional with 1.5 mM calcium in HD. The secondary objective is to evaluate the performance in the medium term of purifying the concentrate with 1 mM citrate and Ca\_eq, compared to traditional concentrated with 3 mM acetate and 1.5 mM calcium in HD.

Detailed Description

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Primary Objective The primary objective of this study is to find the formulation of calcium (1.50, 1.65 and 1.75 mM) in the bath with 1 mM citrate which allows the equivalence of calcium balance (Ca\_eq) in a sitting HD compared to traditional concentrated with 3 mM of calcium acetate and 1.5.

Secondary objectives

* Evaluate the purifying performance of small and medium-sized molecules in HD with concentrated with 1 mM citrate and Ca\_eq compared to traditional concentrated with 3 mM calcium acetate and 1.5.
* Observe the effects on hemodynamic of the concentrate through the variation of the pre and post-dialysis blood pressure and intradialytic symptoms (cramps, hypotension, headache).
* Evaluate the variations of the parameters of mineral metabolism: Predialytic values of PTH, alkaline phosphatase treatments with concentrated Cit (1 mM citrate and Ca\_eq) and concentrated with traditional Ac (3 mM calcium acetate and 1.5).

Conditions

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ESRD

Keywords

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calcium balance dialysis concentrate with citrate

Study Design

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Observational Model Type

CASE_CROSSOVER

Study Time Perspective

PROSPECTIVE

Study Groups

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Bath with citrate

Each patient will participate in two phases of the study. The first phase has the aim to identify the concentration of calcium in the bath with citrate which allows the equivalence of mass balance (Ca\_eq) compared to the concentrate with 3 mM acetate and 1.5 mM of calcium (4 weeks). Each week, the concentration of calcium in the bath with citrate is increased from 1.5-, to 1.65, to 1.75 mM.

•Concentrate SelectBag One (with 3 mM acetic acid) and SelectBag Citrate (with 1 mM of citric acid). The potassium in the bath will be chosen on the basis of the needs of the patient (2 to 3.5 mM) and will be maintained in all concentrates.•All treatment parameters (Qb, time of treatment, weight loss and anticoagulant dose) should be overlapped at all stages of the study

Bath with citrate

Intervention Type DEVICE

bath with citrate which allows the equivalence of mass balance (Ca\_eq) compared to the concentrate with 3 mM acetate and 1.5 mM of calcium

Bath with citrate and Ca_eq

Each patient will participate in two phases of the study. In the second phase will evaluate the effectiveness of the purification concentrate with 1 mM citrate and Ca\_eq compared to the concentrate with 3 mM acetate and 1.5 mM calcium. For each of the sessions will be used the following materials:

* Filter high permeability (Kuf\> 20ml/mmHg);
* Concentrate SelectBag One (with 3 mM acetic acid) and SelectBag Citrate (with 1 mM of citric acid). The potassium in the bath will be chosen on the basis of the needs of the patient (2 to 3.5 mM) and will be maintained in all concentrates.
* All treatment parameters (Qb, time of treatment, weight loss and anticoagulant dose) should be overlapped at all stages of the study.

Bath with citrate and Ca_eq

Intervention Type DEVICE

bath with citrate and Ca\_eq of concentrate with 3 mM acetate and 1.5 mM of calcium

Interventions

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Bath with citrate

bath with citrate which allows the equivalence of mass balance (Ca\_eq) compared to the concentrate with 3 mM acetate and 1.5 mM of calcium

Intervention Type DEVICE

Bath with citrate and Ca_eq

bath with citrate and Ca\_eq of concentrate with 3 mM acetate and 1.5 mM of calcium

Intervention Type DEVICE

Other Intervention Names

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Select Bag Citrate Select Bag Citrate

Eligibility Criteria

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Inclusion Criteria

* Patients clinically stable.

* age\> 18 years.
* HD therapy for more than 3 months.
* good vascular access native functionality that enables real blood flow of at least 250 ml / min.

Exclusion Criteria

* Patients with the features listed below may not be enrolled in this survey:

* Life expectancy \<6 months.
* residual diuresis\> 500 ml / day.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AO Garbagnate-Bollate

UNKNOWN

Sponsor Role collaborator

Azienda Ospedaliera, Ospedale Civile di Legnano

OTHER

Sponsor Role lead

Responsible Party

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Carlo Maria Guastoni

DPT Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carlo Maria Guastoni, DR

Role: PRINCIPAL_INVESTIGATOR

Asst Ovest Mi

Locations

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Carlo Maria Guastoni

Legnano, Milano, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Carlo Maria Guastoni, DR

Role: CONTACT

Phone: +39 3482807180

Email: [email protected]

Ugo Teatini, DR

Role: CONTACT

Phone: +39 347 8851870

Email: [email protected]

Facility Contacts

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Carlo Maria Guastoni, DR

Role: primary

Ugo Teatini, DR

Role: backup

References

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Ahmad S, Callan R, Cole JJ, Blagg CR. Dialysate made from dry chemicals using citric acid increases dialysis dose. Am J Kidney Dis. 2000 Mar;35(3):493-9. doi: 10.1016/s0272-6386(00)70203-4.

Reference Type BACKGROUND
PMID: 10692276 (View on PubMed)

Bauer E, Derfler K, Joukhadar C, Druml W. Citrate kinetics in patients receiving long-term hemodialysis therapy. Am J Kidney Dis. 2005 Nov;46(5):903-7. doi: 10.1053/j.ajkd.2005.07.041.

Reference Type BACKGROUND
PMID: 16253731 (View on PubMed)

Kossmann RJ, Gonzales A, Callan R, Ahmad S. Increased efficiency of hemodialysis with citrate dialysate: a prospective controlled study. Clin J Am Soc Nephrol. 2009 Sep;4(9):1459-64. doi: 10.2215/CJN.02590409. Epub 2009 Aug 6.

Reference Type BACKGROUND
PMID: 19661218 (View on PubMed)

Bosticardo G, Malberti F, Basile C, Leardini L, Libutti P, Filiberti O, Schillaci E, Ravani P. Optimizing the dialysate calcium concentration in bicarbonate haemodialysis. Nephrol Dial Transplant. 2012 Jun;27(6):2489-96. doi: 10.1093/ndt/gfr733. Epub 2012 Feb 21.

Reference Type BACKGROUND
PMID: 22357700 (View on PubMed)

Other Identifiers

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CT-050313

Identifier Type: -

Identifier Source: org_study_id