Trial of Variable Dialysate Bicarbonate

NCT ID: NCT05814146

Last Updated: 2025-11-24

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

RECRUITING

Clinical Phase

NA

Total Enrollment

141 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-24

Study Completion Date

2026-10-01

Brief Summary

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QTc prolongation and premature ventricular contractions (PVCs) are common in hemodialysis (HD) patients and are associated with sudden cardiac death.

It is known that higher dialysate bicarbonate is associated with more QTc prolongation during HD sessions.

This study aims to assess the effects of lower (30 mEq/L) versus higher (35 mEq/L) dialysate bicarbonate in adult maintenance HD patients admitted to the hospital.

The investigators will randomly assign subjects to lower versus higher dialysate bicarbonate concentrations during their hospital stay for up to a maximum of six HD sessions or until their hospital discharge.

Detailed Description

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Conditions

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Peri-dialytic Cardiac Rhythms Intradialytic Hypotension Electrolyte Changes pH Changes Adverse Symptoms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Lower dialysate bicarbonate

A lower dialysate bicarbonate will be used in the experimental arm (30 mEq/L).

Group Type EXPERIMENTAL

Dialysate bicarbonate concentration

Intervention Type DRUG

Assess how a lower dialysate bicarbonate affects:

* QTc duration during and between hemodialysis sessions
* PVC burden during and between hemodialysis sessions
* Clinically significant arrhythmia during and between hemodialysis sessions
* Intradialytic hypotension
* Adverse symptoms during hemodialysis sessions

Dialysate bicarbonate concentration - telemetry monitoring

Intervention Type DEVICE

Patients will be monitored with telemetry on both arms of the trial.

Higher dialysate bicarbonate

A higher dialysate bicarbonate will be used in the active comparator arm (35 mEq/L).

Group Type ACTIVE_COMPARATOR

Dialysate bicarbonate concentration

Intervention Type DRUG

Assess how a lower dialysate bicarbonate affects:

* QTc duration during and between hemodialysis sessions
* PVC burden during and between hemodialysis sessions
* Clinically significant arrhythmia during and between hemodialysis sessions
* Intradialytic hypotension
* Adverse symptoms during hemodialysis sessions

Dialysate bicarbonate concentration - telemetry monitoring

Intervention Type DEVICE

Patients will be monitored with telemetry on both arms of the trial.

Interventions

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Dialysate bicarbonate concentration

Assess how a lower dialysate bicarbonate affects:

* QTc duration during and between hemodialysis sessions
* PVC burden during and between hemodialysis sessions
* Clinically significant arrhythmia during and between hemodialysis sessions
* Intradialytic hypotension
* Adverse symptoms during hemodialysis sessions

Intervention Type DRUG

Dialysate bicarbonate concentration - telemetry monitoring

Patients will be monitored with telemetry on both arms of the trial.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* prevalent end-stage renal disease, on maintenance HD \> 90 days
* age ≥ 18 years old
* thrice weekly HD

Exclusion Criteria

* hemoglobin \< 8.0 g/dL
* pregnancy
* any physical, mental or medical condition which limited the ability to provide written informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Katherine Scovner Ravi, MD, MPH

Instructor Harvard Medical School / Associate Physician Renal Division

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Katherine S Ravi, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

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Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Katherine S Ravi, MD, MPH

Role: CONTACT

(617) 732-6383

Facility Contacts

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Katherine S Ravi, MD, MPH

Role: primary

617-732-6383

Other Identifiers

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2022P002944

Identifier Type: -

Identifier Source: org_study_id

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