Alternative Haemodiafiltration in Summer Season for Chronic Kidney Disease Patients

NCT ID: NCT05861219

Last Updated: 2023-05-16

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

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-21

Study Completion Date

2025-06-21

Brief Summary

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Hemodiafiltration is a renal replacement technique combining diffusion and convection to enhance solute removal. Post dialyser replacement fluid is administered to achieve the target fluid balance. The skin is the largest human organ playing an important role in thermal and Na regulation and skin blood flow is 8.5-10%of cardiac output .

Detailed Description

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Sweat contains electrolytes, creatinine and urea, with higher excretion by mild physical exercise. These findings motivate studies investigating the effect of stimulated sweating on volume control in kidney disease patients. Using sweat as the vehicle for removing molecules normally excreted in the urine was identified some decades ago. sweat urea concentration could reach 5.5 to 50 times the serum concentration .

Physical inactivity was reported as the fourth leading cause of death from chronic disease worldwide. Warm water immersion (37-46◦C) increases limb blood flow, and muscle heating activates regulators of mitochondrial biogenesis. water immersion represent diffusion .the average person sweats between (0.8- 1.4) liters during an hour of exercise, drinking water represent water replacement .

Particularly, urea concentrations in sweat are persistently elevated in uremic patients. The 24-hour urinary urea excretion in summer was 1/4 the quantity in winter in uremic patients, indicating the compensatory urea excretion in sweat gland fluid . Sweat glands are inactive except above 29°C, due to a concentration gradient within the stratum corneum, results in continuous water convection from within the body through the skin and into the environment.

In our study we stimulate sweating of chronic kidney disease patients through mild physical activity as walking then they immersied in water to enhance waste excretion through skin.Evaluation of these patients will be done through following up blood pressure,laboratory investigations as kidney function test sodium, potassium,phosphorus levels and uric acid.

Conditions

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Sweating

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Chronic kidney disease stage 3,4
Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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chronic kidney disease patients stage 3 and 4

50 chronic kidney disease patients stage 3 and 4 will perform mild exercise and water immersion

Group Type EXPERIMENTAL

water immersion

Intervention Type BEHAVIORAL

mild physical activity then water immersion in tub

Interventions

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water immersion

mild physical activity then water immersion in tub

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

chronic kidney disease group:

1. stage 3,4
2. Age(18-60)yrs old.
3. Not on dialysis.
4. Without uremic symptoms nor standard indication for dialysis

Exclusion Criteria

1. History of cerebrovascular accidents.
2. History of advanced cardiac disease (heart failure, recent acute coronary syndrome, and cardiac arrhythmia).
3. Active skin lesion
4. volume overload. 5- advanced liver cirrhosis, respiratory failure, and malignancy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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MANAR SALAH AHMED BARAKAT

assisstant lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ashraf Elshazly, professor

Role: STUDY_CHAIR

professor

Central Contacts

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manar salah

Role: CONTACT

01092058750

khalid Ali

Role: CONTACT

References

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Ronco C. Hemodiafiltration: Technical and Clinical Issues. Blood Purif. 2015;40 Suppl 1:2-11. doi: 10.1159/000437403. Epub 2015 Sep 8.

Reference Type BACKGROUND
PMID: 26344507 (View on PubMed)

Baker LB. Physiology of sweat gland function: The roles of sweating and sweat composition in human health. Temperature (Austin). 2019 Jul 17;6(3):211-259. doi: 10.1080/23328940.2019.1632145. eCollection 2019.

Reference Type BACKGROUND
PMID: 31608304 (View on PubMed)

Huang CT, Chen ML, Huang LL, Mao IF. Uric acid and urea in human sweat. Chin J Physiol. 2002 Sep 30;45(3):109-15.

Reference Type BACKGROUND
PMID: 12817713 (View on PubMed)

Blank IH, Moloney J 3rd, Emslie AG, Simon I, Apt C. The diffusion of water across the stratum corneum as a function of its water content. J Invest Dermatol. 1984 Feb;82(2):188-94. doi: 10.1111/1523-1747.ep12259835.

Reference Type BACKGROUND
PMID: 6693781 (View on PubMed)

Joo CH, Allan R, Drust B, Close GL, Jeong TS, Bartlett JD, Mawhinney C, Louhelainen J, Morton JP, Gregson W. Passive and post-exercise cold-water immersion augments PGC-1alpha and VEGF expression in human skeletal muscle. Eur J Appl Physiol. 2016 Dec;116(11-12):2315-2326. doi: 10.1007/s00421-016-3480-1. Epub 2016 Oct 3.

Reference Type BACKGROUND
PMID: 27699485 (View on PubMed)

al-Tamer YY, Hadi EA, al-Badrani II. Sweat urea, uric acid and creatinine concentrations in uraemic patients. Urol Res. 1997;25(5):337-40. doi: 10.1007/BF01294662.

Reference Type BACKGROUND
PMID: 9373914 (View on PubMed)

Other Identifiers

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alternative HDF in CKD

Identifier Type: -

Identifier Source: org_study_id

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