Benefits of Hemodialysis With Citrate (ABC-treat) Study

NCT ID: NCT03319680

Last Updated: 2017-10-24

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

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-31

Study Completion Date

2017-12-31

Brief Summary

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Prospective randomized cross-over multicenter study to demonstrate the benefits of hemodialysis without acetate dialysate, with citrate.

32 weeks duration, in two phases. In the first, half of the patients started with citrate dialysate for 16 weeks and the other half with acetate dialysate, and then patients cross.

The primary objective is to analyze the effect of citrate dialysate on acid base balance decreasing chronic metabolic acidosis and avoiding / reducing post-dialytic alkalosis.

Detailed Description

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Primary objective: to analyze the effect of citrate dialysate on acid base balance decreasing chronic metabolic acidosis and avoiding / reducing post-dialytic alkalosis.

Secondary objectives:

* Evaluate the effect of dialysate on the variation of calcium pre and post-dialytic, as well as on the parathormone (PTH)
* Assess the effect of dialysate on inflammation
* Assess the effect of dialysate on the Elimination of small and medium-sized molecules
* Assess the effect of dialysate on the tolerance to the hemodialysis sessions
* Assess the effect of dialysate on nutritional parameters

Patients: Adult patients dialysed three times per week for at least 3 months will be enrolled in 12 Spanish dialysis centres. Catheter as vascular access will be excluded.

Design: prospective randomized multicenter, cross-over trial of chronic haemodialysis patients to compare the effect of citrate dialysate with acetate dialysate.

Duration of study: 32 weeks, in two phases. Randomised to 16 weeks of hemodialysis with acetate followed by 16 weeks of citrate or 16 weeks of hemodialysis with citrate followed by 16 weeks of acetate. Each patient will serve as control of itself and there will be no changes in the pattern of dialysis during the study with the exception of the dialysate, following the usual pattern of work

Conditions

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Hemodialysis-Induced Symptom

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Citrate dialysate

Hemodialysis with citrate dialysate during 16 weeks

Group Type ACTIVE_COMPARATOR

Citrate dialysate

Intervention Type OTHER

Compare the effect of citrate dialysate with acetate dialysate

Acetate dialysate

Hemodialysis with acetate dialysate during 16 weeks

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Citrate dialysate

Compare the effect of citrate dialysate with acetate dialysate

Intervention Type OTHER

Other Intervention Names

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Acetate dialysate

Eligibility Criteria

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Inclusion Criteria

* Outpatient conventional hemodialysis three times per week for at least three months.
* Arteriovenous fistula as vascular access
* Patients who have given their informed consent in writing.

Exclusion Criteria

* Catheter as vascular access
* Allergy or intolerance to citrate
* Patients with sufficient cognitive impairment that would prevent the compression of information and informed consent.
* Inflammatory intercurrent diseases (chronic infections, autoimmune diseases or tumors) that can mask the results of the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baxter Healthcare Corporation

INDUSTRY

Sponsor Role collaborator

Fundación Senefro

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rafael Perez-Garcia, PhD

Role: PRINCIPAL_INVESTIGATOR

Nephrology department. Hospital universitario Infanta Leonor

Locations

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Hospital General de Castellón

Castellon, Castellón, Spain

Site Status RECRUITING

Hospital del Henares

Coslada, Madrid, Spain

Site Status RECRUITING

Hospital Universitario Infanta Sofía

San Sebastián de los Reyes, Madrid, Spain

Site Status RECRUITING

Hospital Universitario Santa Lucía

Cartagena, Murcia, Spain

Site Status RECRUITING

Hospital de Basurto

Bilbao, Vizcaya, Spain

Site Status RECRUITING

Hospital de Galdakao

Usansolo, Vizcaya, Spain

Site Status RECRUITING

Hospital Universitario de Guadalajara

Guadalajara, , Spain

Site Status RECRUITING

Universitary Hospital Infanta Leonor

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status RECRUITING

Complexo Hospitalario Universitario de Ourense

Ourense, , Spain

Site Status RECRUITING

Hospital Universitario Virgen de la Macarena

Seville, , Spain

Site Status RECRUITING

Hospital Universitario Virgen del Rocío

Seville, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Patricia de Sequera, PhD

Role: CONTACT

Phone: 911918502

Email: [email protected]

Manuel Molina, PhD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Ramón Pons

Role: primary

Blanca Bueno

Role: primary

Rocio Echarri

Role: primary

Gracia Alvarez

Role: primary

Iñigo Moina

Role: primary

Rosa Inés Muñoz

Role: primary

Gabriel De Arriba

Role: primary

Patricia de Sequera, PhD

Role: primary

Eva Mérida

Role: primary

Alfoso Otero

Role: primary

Rocío Valverde

Role: primary

Luis Gil

Role: primary

References

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Gabutti L, Lucchini B, Marone C, Alberio L, Burnier M. Citrate- vs. acetate-based dialysate in bicarbonate haemodialysis: consequences on haemodynamics, coagulation, acid-base status, and electrolytes. BMC Nephrol. 2009 Mar 5;10:7. doi: 10.1186/1471-2369-10-7.

Reference Type BACKGROUND
PMID: 19265544 (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)

Bryland A, Wieslander A, Carlsson O, Hellmark T, Godaly G. Citrate treatment reduces endothelial death and inflammation under hyperglycaemic conditions. Diab Vasc Dis Res. 2012 Jan;9(1):42-51. doi: 10.1177/1479164111424297. Epub 2011 Nov 1.

Reference Type BACKGROUND
PMID: 22045866 (View on PubMed)

Daimon S, Dan K, Kawano M. Comparison of acetate-free citrate hemodialysis and bicarbonate hemodialysis regarding the effect of intra-dialysis hypotension and post-dialysis malaise. Ther Apher Dial. 2011 Oct;15(5):460-5. doi: 10.1111/j.1744-9987.2011.00976.x.

Reference Type BACKGROUND
PMID: 21974699 (View on PubMed)

Grundstrom G, Christensson A, Alquist M, Nilsson LG, Segelmark M. Replacement of acetate with citrate in dialysis fluid: a randomized clinical trial of short term safety and fluid biocompatibility. BMC Nephrol. 2013 Oct 9;14:216. doi: 10.1186/1471-2369-14-216.

Reference Type BACKGROUND
PMID: 24103587 (View on PubMed)

Molina Nunez M, de Alarcon R, Roca S, Alvarez G, Ros MS, Jimeno C, Bucalo L, Villegas I, Garcia MA. Citrate versus acetate-based dialysate in on-line haemodiafiltration. A prospective cross-over study. Blood Purif. 2015;39(1-3):181-187. doi: 10.1159/000371569.

Reference Type BACKGROUND
PMID: 25791278 (View on PubMed)

Kuragano T, Kida A, Furuta M, Yahiro M, Kitamura R, Otaki Y, Nonoguchi H, Matsumoto A, Nakanishi T. Effects of acetate-free citrate-containing dialysate on metabolic acidosis, anemia, and malnutrition in hemodialysis patients. Artif Organs. 2012 Mar;36(3):282-90. doi: 10.1111/j.1525-1594.2011.01349.x. Epub 2011 Sep 29.

Reference Type BACKGROUND
PMID: 21954915 (View on PubMed)

Natale P, Palmer SC, Ruospo M, Longmuir H, Dodds B, Prasad R, Batt TJ, Jose MD, Strippoli GF. Anticoagulation for people receiving long-term haemodialysis. Cochrane Database Syst Rev. 2024 Jan 8;1(1):CD011858. doi: 10.1002/14651858.CD011858.pub2.

Reference Type DERIVED
PMID: 38189593 (View on PubMed)

de Sequera Ortiz P, Perez Garcia R, Molina Nunez M, Munoz Gonzalez RI, Alvarez Fernandez G, Merida Herrero E, Camba Caride MJ, Blazquez Collado LA, Alcaide Lara MP, Echarri Carrillo R; en representacion del grupo del estudio ABC-treat; Grupo del estudio ABC-treat. Prospective randomised multicentre study to demonstrate the benefits of haemodialysis without acetate (with citrate): ABC-treat Study. Acute effect of citrate. Nefrologia (Engl Ed). 2019 Jul-Aug;39(4):424-433. doi: 10.1016/j.nefro.2018.11.002. Epub 2019 Jan 24. English, Spanish.

Reference Type DERIVED
PMID: 30686542 (View on PubMed)

Related Links

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http://www.senefro.org/

Sponsor web page

Other Identifiers

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ABC-Treat

Identifier Type: -

Identifier Source: org_study_id