Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This study was designed to compare the efficacy of BIA and physician adjustment to prevent intradialytic hypotension in patients with acute kidney injury who received renal replacement therapy. The investigators randomized 9 patients with acute kidney injury and volume overloaded who underwent acute hemodialysis for 45 sessions in Vajira hospital between October 2017 and February 2018. In physician adjust-group (control) estimate by physical examination and fluid balance record. Primary outcome was intradialytic hypotensive episode and secondary outcome was hemodialysis-related adverse events and other clinical outcome.
Background
Volume overload and intradialytic hypotension are significant complications with increasing mortality rate in hemodialysis patients. Bioelectrical Impedance Analysis (BIA) has been used to estimate the optimum weight in chronic hemodialysis patient to prevent intradialytic hypotension.Volume assessment in acute kidney injury is also of great importance , however, there are currently few methods to obtain an accurate assessment of hydration status in this scenario. This study was designed to compare the efficacy of BIA and physician adjustment to prevent intradialytic hypotension in patients with acute kidney injury who received renal replacement therapy.
Methods
The investigators randomized 9 patients with acute kidney injury and volume overloaded who underwent acute hemodialysis for 45 sessions in Vajira hospital between October 2017 and February 2018. Volume overload was defined by BIA with value more than>0.4. In physician adjust-group (control) estimate by physical examination and fluid balance record. Primary outcome was intradialytic hypotensive episode and secondary outcome was hemodialysis-related adverse events and other clinical outcome.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bioelectrical Impedance | Experimental | The first group will be monitored by Inbody S20 analysis to measure fluid status. The Bioimpedance will be measured each time prior to hemodialysis session . The value of BIA measurement of more than 0.4 will be considered as edema. |
|
| Physicain-guided group | Active Comparator | The fluid monitoring will be managed by physician-adjustment by physical examination and fluid balance record . The fluid balance (FB) is the total fluid administered minus the total fluids eliminated over a period of time. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bioelectrical Impedance Analysis | Device | We use Inbody S20 analysis to measure fluid status before each hemodialysis session to guide fluid removal. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in blood pressure during dialysis | Blood pressure less than 20 mmHg from baseline ( systolic blood pressure) | During hemodialysis session start from enrollment until study completion, up to 4 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiac problem | Number of patients that have palpitation,cardiac arrthymia or chest pain | Measure through study completion,for at least 3 months after randomization |
| Hospital length of stay | Total days in admission |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Patients who were pregnant
More than 18 years old
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Thananda Trakarnvanich | Vajira Hospital ,Navamindradhiraj University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Thananda Trakarnvanich | Bangkok | Bangkok | 10170 | Thailand |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Prospective randomized study
Not provided
Not provided
Not provided
Not provided
| Physician-guided | Procedure | This intervention used physical examination as guided to adjust fluid therapy together with the chart record of intake and output per day |
|
|
| Up to 3 months after enrollment |
| Percent of renal function | eGFR | at least 3 months after enrollment |
| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D051437 | Renal Insufficiency |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
Not provided
Not provided