Mechanisms and Phenotypes of Hypertension in Patients in Chronic Hemodialysis
NCT ID: NCT06764277
Last Updated: 2025-06-10
Study Results
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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COMPLETED
40 participants
OBSERVATIONAL
2023-08-14
2025-06-06
Brief Summary
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The main question to be answered is: What is the relative importance of weight gain, the renin angiotensin system, the sympathetic nervous system and inflammatory immune reactivity in the hypertension of patients in chronic hemodialysis, The participantes will have hemodynamic evaluation (cardiac output and peripheral vascular resistance) at the end of dialysis, ambulatory monitoring of blood pressure in the interdialytic period and before the next dialysis (2-3 days later). Serum samples will be collected at the end of dialysis and before the start of the next dialysis, 2-3 days later.
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Detailed Description
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* Weight (kilograms) changes will be studied after dialysis and before the next dialysis sesion (2-3 days later)
* Serum samples will be obtained at the end of dialysis and before the next sesion (2-3 days later).
* ultrasound estimation of cardiac output and peripheral vascular rersistance will be done after dialysis
* Ambulatory blood pressure monitoring will be done in the interdialytic period (24-48 hours) between the end of dialysis and the next dialysis sesion.
* If possible there will be a predialysis study of bioimpedance. Associations of weight gain (kilograms), serum angiotensin II and angiotensin 1-7 (pg/ml), levels of IL-6 (pg/ml), IL-17 (pg/ml), IL-10 (pg/ml), TNFalpha (pg/ml), copeptin levels(pg/ml) and norepinephrin levels (pg/ml) with systolic and diastolic blood pressure (mmHg) before and after dialysis will be explored.
* Phenotypes of blood pressure (sustained hypertension, nocturnal and diurnal hypertension, dippers, non-dippers, extreme dippers and reverse dippers) hypertension determined by ambulatory monitoring will be studied in relation of levels of angiotensin II, immune inflammatory markers, copeptin and norepinephrin leves.
All serum levels will be determined by commercial ELISA kits,
Conditions
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Study Design
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COHORT
PROSPECTIVE
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* Patients with active infection
* Patients with prostesis or pacemakers
* Patients with immunosuppresive treatment equivalent to more than 15mg Prednisone daily
18 Years
ALL
No
Sponsors
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Bernardo Rodríguez Iturbe
OTHER
Responsible Party
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Bernardo Rodríguez Iturbe
Researcher
Principal Investigators
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Bernardo RODRIGUEZITURBE, MD, PhD
Role: PRINCIPAL_INVESTIGATOR
Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubirán"
Locations
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Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán"
Mexico City, , Mexico
Countries
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References
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Rodriguez-Iturbe B. Autoimmunity in the Pathogenesis of Hypertension. Hypertension. 2016 Mar;67(3):477-83. doi: 10.1161/HYPERTENSIONAHA.115.06418. Epub 2015 Dec 7. No abstract available.
Fay KS, Cohen DL. Resistant Hypertension in People With CKD: A Review. Am J Kidney Dis. 2021 Jan;77(1):110-121. doi: 10.1053/j.ajkd.2020.04.017. Epub 2020 Jul 23.
Abais-Battad JM, Rudemiller NP, Mattson DL. Hypertension and immunity: mechanisms of T cell activation and pathways of hypertension. Curr Opin Nephrol Hypertens. 2015 Sep;24(5):470-4. doi: 10.1097/MNH.0000000000000146.
Agarwal R, Weir MR. Dry-weight: a concept revisited in an effort to avoid medication-directed approaches for blood pressure control in hemodialysis patients. Clin J Am Soc Nephrol. 2010 Jul;5(7):1255-60. doi: 10.2215/CJN.01760210. Epub 2010 May 27.
Rodriguez-Iturbe B, Pons H, Johnson RJ. Role of the Immune System in Hypertension. Physiol Rev. 2017 Jul 1;97(3):1127-1164. doi: 10.1152/physrev.00031.2016.
Neumann J, Ligtenberg G, Klein II, Koomans HA, Blankestijn PJ. Sympathetic hyperactivity in chronic kidney disease: pathogenesis, clinical relevance, and treatment. Kidney Int. 2004 May;65(5):1568-76. doi: 10.1111/j.1523-1755.2004.00552.x.
Kim KE, Onesti G, Schwartz AB, Chinitz JL, Swartz C. Hemodynamics of hypertension in chronic end-stage renal disease. Circulation. 1972 Sep;46(3):456-64. doi: 10.1161/01.cir.46.3.456. No abstract available.
Buckalew VM Jr, Berg RL, Wang SR, Porush JG, Rauch S, Schulman G. Prevalence of hypertension in 1,795 subjects with chronic renal disease: the modification of diet in renal disease study baseline cohort. Modification of Diet in Renal Disease Study Group. Am J Kidney Dis. 1996 Dec;28(6):811-21. doi: 10.1016/s0272-6386(96)90380-7.
Saad E, Charra B, Raj DS. Hypertension control with daily dialysis. Semin Dial. 2004 Jul-Aug;17(4):295-8. doi: 10.1111/j.0894-0959.2004.17330.x.
Other Identifiers
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NMM-4512-23-24-1
Identifier Type: -
Identifier Source: org_study_id
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