Effect of Protein Intake During Hemodialysis on Blood Pressure and Arterial Stiffness Indices

NCT ID: NCT03947710

Last Updated: 2020-01-07

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

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-01

Study Completion Date

2020-08-01

Brief Summary

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Open label, randomized, cross-over clinical study comparing the acute effect of high versus low protein meals during dialysis on intradialytic blood pressure, 24-hour ambulatory blood pressure and arterial stiffness indices on maintenance hemodialysis patients.

Detailed Description

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A series of demographic, anthropometric and clinical data will be collected prior to enrollment. The intervention will last 3 consecutive weeks. Eligible subjects will be randomised to one group (high or low protein meals during dialysis) for one week (3 dialysis sessions). Second week will be a wash out period (patients will not consume meals during dialysis) and during the third week randomised subjects will cross over to the other study group. Every meal will provide 1/3 of daily recommended energy and protein intake (35 kcal/kg body weight/day, 0.7 gr protein/kg body weight/day for low protein meals and 1.5 gr protein/kg body weight/day for high protein meals). All the meals will be prepared in the hospital's kitchen and will be personalized to each patient's preferences. The meal will be given one hour after the start of the session and should be consumed completely during dialysis.

Patients will be evaluated for the following parameters during their midweek dialysis session:

1. Intradialytic blood pressure
2. 24-hour ambulatory blood pressure
3. Arterial stiffness indices (Central Aortic blood pressure, Pulse Wave Velocity, Augmentation Index)
4. Hemodialysis adequacy
5. Nutritional status

Intradialytic blood pressure, 24-hour ambulatory blood pressure and arterial stiffness indices will be evaluated with the use of the brachial cuff-based oscillometric device Mobil-O-Graph NG (IEM, Stolberg, Germany). Urea reduction ratio (URR) and Kt/V (standard and equilibrated) will be used as measures for dialysis adequacy. Possible changes in patients nutritional status will be assessed using the Malnutrition-Inflammation Score (MIS).

Conditions

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End Stage Renal Disease Hypotension During Dialysis Protein Malnutrition Arterial Sclerosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Open label, randomized, cross-over clinical study.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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High-protein meals

Patients with End Stage Renal disease on maintenance hemodialysis will consume high protein meals during their dialysis sessions for one week.

Group Type EXPERIMENTAL

High-protein meals

Intervention Type OTHER

Patients on maintenance hemodialysis will consume high protein meals during dialysis for one week (3 dialysis sessions)

Low-protein meals

Patients with End Stage Renal disease on maintenance hemodialysis will consume low protein meals during their dialysis sessions for one week

Group Type EXPERIMENTAL

Low- protein meals

Intervention Type OTHER

Patients on maintenance hemodialysis will consume low protein meals during dialysis for one week (3 dialysis sessions)

No meals

Patients with End Stage Renal disease on maintenance hemodialysis will not consume meals during their dialysis sessions for one week

Group Type EXPERIMENTAL

No meals

Intervention Type OTHER

Patients on maintenance hemodialysis will not consume meals during dialysis for one week (3 dialysis sessions)

Interventions

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High-protein meals

Patients on maintenance hemodialysis will consume high protein meals during dialysis for one week (3 dialysis sessions)

Intervention Type OTHER

Low- protein meals

Patients on maintenance hemodialysis will consume low protein meals during dialysis for one week (3 dialysis sessions)

Intervention Type OTHER

No meals

Patients on maintenance hemodialysis will not consume meals during dialysis for one week (3 dialysis sessions)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients to have provided informed written consent
* Patients undergoing maintenance hemodialysis for at least 3 months prior to enrollment
* Ability to self-ingest food during the dialysis session

Exclusion Criteria

* History of malignancy or any other clinical condition associated with very poor prognosis
* Hospitalization for acute myocardial infarction, unstable angina or acute ischemic stroke within the 3 previous months
* Patients receiving parenteral nutrition
* Body mass index (BMI) of \>40 kg/m2
* Bilateral functioning or non-functioning arteriovenous fistula (AVF) and/or arteriovenous graft (AVG) used as dialysis access
* Patients with major amputations (eg lower limbs)
* Women during pregnancy or lactation
* Patients with unsuccessful 24-hour ambulatory recording of blood pressure with Mobil-O-Graph device, in accordance with the current European Society of Hypertension Guidelines.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aristotle University Of Thessaloniki

OTHER

Sponsor Role lead

Responsible Party

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Vaios Vasileios

Vaios Vasileios, Resident in Nephrology, Department of Nephrology and Hypertension, AHEPA University Hospital, Aristotle University Of Thessaloniki

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Vassilios Liakopoulos, MD, PhD

Role: STUDY_CHAIR

Department of Medicine, Aristotle University of Thessaloniki

Elena Fotiadou

Role: STUDY_DIRECTOR

Department of Nutrition and Dietetics, AHEPA University Hospital, Thessaloniki

Locations

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AHEPA University Hospital

Thessaloniki, Select A State/Province, Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Vasileios Vaios, MD

Role: CONTACT

+306984568904

Facility Contacts

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Vassilios Liakopoulos

Role: primary

6932293544

References

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Caglar K, Fedje L, Dimmitt R, Hakim RM, Shyr Y, Ikizler TA. Therapeutic effects of oral nutritional supplementation during hemodialysis. Kidney Int. 2002 Sep;62(3):1054-9. doi: 10.1046/j.1523-1755.2002.00530.x.

Reference Type BACKGROUND
PMID: 12164890 (View on PubMed)

Burrowes JD, Larive B, Cockram DB, Dwyer J, Kusek JW, McLeroy S, Poole D, Rocco MV; Hemodialysis (HEMO) Study Group. Effects of dietary intake, appetite, and eating habits on dialysis and non-dialysis treatment days in hemodialysis patients: cross-sectional results from the HEMO study. J Ren Nutr. 2003 Jul;13(3):191-8. doi: 10.1016/s1051-2276(03)00069-4.

Reference Type BACKGROUND
PMID: 12874743 (View on PubMed)

Rhee CM, You AS, Koontz Parsons T, Tortorici AR, Bross R, St-Jules DE, Jing J, Lee ML, Benner D, Kovesdy CP, Mehrotra R, Kopple JD, Kalantar-Zadeh K. Effect of high-protein meals during hemodialysis combined with lanthanum carbonate in hypoalbuminemic dialysis patients: findings from the FrEDI randomized controlled trial. Nephrol Dial Transplant. 2017 Jul 1;32(7):1233-1243. doi: 10.1093/ndt/gfw323.

Reference Type BACKGROUND
PMID: 27659126 (View on PubMed)

Jansen RW, Lipsitz LA. Postprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med. 1995 Feb 15;122(4):286-95. doi: 10.7326/0003-4819-122-4-199502150-00009.

Reference Type BACKGROUND
PMID: 7825766 (View on PubMed)

Choi MS, Kistler B, Wiese GN, Stremke ER, Wright AJ, Moorthi RN, Moe SM, Hill Gallant KM. Pilot Study of the Effects of High-Protein Meals During Hemodialysis on Intradialytic Hypotension in Patients Undergoing Maintenance Hemodialysis. J Ren Nutr. 2019 Mar;29(2):102-111. doi: 10.1053/j.jrn.2018.06.002. Epub 2018 Aug 11.

Reference Type BACKGROUND
PMID: 30107974 (View on PubMed)

Kistler B, Benner D, Burgess M, Stasios M, Kalantar-Zadeh K, Wilund KR. To eat or not to eat-international experiences with eating during hemodialysis treatment. J Ren Nutr. 2014 Nov;24(6):349-52. doi: 10.1053/j.jrn.2014.08.003. Epub 2014 Oct 22.

Reference Type BACKGROUND
PMID: 25443543 (View on PubMed)

Sarafidis PA, Georgianos PI, Karpetas A, Bikos A, Korelidou L, Tersi M, Divanis D, Tzanis G, Mavromatidis K, Liakopoulos V, Zebekakis PE, Lasaridis A, Protogerou AD. Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in hemodialysis patients. Am J Nephrol. 2014;40(3):242-50. doi: 10.1159/000367791. Epub 2014 Oct 11.

Reference Type BACKGROUND
PMID: 25322847 (View on PubMed)

San Juan Miguelsanz M, Pilar SM, Santos de Pablos MR. Reduction of Kt/V by food intake during haemodialysis. EDTNA ERCA J. 2001 Jul-Sep;27(3):150-2. doi: 10.1111/j.1755-6686.2001.tb00165.x.

Reference Type BACKGROUND
PMID: 11868999 (View on PubMed)

Borzou SR, Mahdipour F, Oshvandi K, Salavati M, Alimohammadi N. Effect of Mealtime During Hemodialysis on Patients' Complications. J Caring Sci. 2016 Dec 1;5(4):277-286. doi: 10.15171/jcs.2016.029. eCollection 2016 Dec.

Reference Type BACKGROUND
PMID: 28032072 (View on PubMed)

Bossola M, Luciani G, Rosa F, Tazza L. Appetite and gastrointestinal symptoms in chronic hemodialysis patients. J Ren Nutr. 2011 Nov;21(6):448-54. doi: 10.1053/j.jrn.2010.09.003. Epub 2011 Jan 15.

Reference Type BACKGROUND
PMID: 21239186 (View on PubMed)

Sherman RA, Torres F, Cody RP. Postprandial blood pressure changes during hemodialysis. Am J Kidney Dis. 1988 Jul;12(1):37-9. doi: 10.1016/s0272-6386(88)80069-6.

Reference Type BACKGROUND
PMID: 3389352 (View on PubMed)

Heymsfield SB, McManus C, Smith J, Stevens V, Nixon DW. Anthropometric measurement of muscle mass: revised equations for calculating bone-free arm muscle area. Am J Clin Nutr. 1982 Oct;36(4):680-90. doi: 10.1093/ajcn/36.4.680.

Reference Type BACKGROUND
PMID: 7124671 (View on PubMed)

Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981 Nov;34(11):2540-5. doi: 10.1093/ajcn/34.11.2540.

Reference Type BACKGROUND
PMID: 6975564 (View on PubMed)

Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974 Jul;32(1):77-97. doi: 10.1079/bjn19740060. No abstract available.

Reference Type BACKGROUND
PMID: 4843734 (View on PubMed)

Malindretos P, Sarafidis P, Spaia S, Sioulis A, Zeggos N, Raptis V, Kitos V, Koronis C, Kabouris C, Zili S, Grekas D. Adaptation and validation of the Kidney Disease Quality of Life-Short Form questionnaire in the Greek language. Am J Nephrol. 2010;31(1):9-14. doi: 10.1159/000252926. Epub 2009 Oct 26.

Reference Type BACKGROUND
PMID: 19864884 (View on PubMed)

Agarwal R, Georgianos P. Feeding during dialysis-risks and uncertainties. Nephrol Dial Transplant. 2018 Jun 1;33(6):917-922. doi: 10.1093/ndt/gfx195.

Reference Type BACKGROUND
PMID: 28633456 (View on PubMed)

Other Identifiers

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MedAuth2

Identifier Type: -

Identifier Source: org_study_id

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