Mannitol - Potential Role in Hemodialysis Initiation for Reduction of Intra-dialytic Hypotension

This study is currently recruiting participants.
Verified February 2013 by Brigham and Women's Hospital
Sponsor:
Information provided by (Responsible Party):
Sushrut S Waikar, Brigham and Women's Hospital
ClinicalTrials.gov Identifier:
NCT01520207
First received: January 25, 2012
Last updated: February 14, 2013
Last verified: February 2013
  Purpose

Kidney failure can result from a variety of conditions and can be temporary or permanent. Hemodialysis is available as a replacement treatment to perform the work that the kidneys normally do. However, the dialysis procedure can be associated with rapid changes in the composition of the blood - this may lead to changes in blood pressure and in turn reduced blood supply to important parts of the body. We aim to investigate if giving a medicine (called mannitol) during dialysis may be able to reduce the frequency of these low blood pressure events.


Condition Intervention
Intra-dialytic Hypotension
Drug: Mannitol (20%)
Drug: 0.9% saline

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Official Title: Pilot Study of Intravenous Mannitol During Hemodialysis Initiation to Reduce the Occurrence of Intra-dialytic Hypotension.

Resource links provided by NLM:


Further study details as provided by Brigham and Women's Hospital:

Primary Outcome Measures:
  • Determine the efficacy of mannitol administration in reducing the frequency of intra-dialytic hypotension during the first three hemodialysis initiation sessions. [ Time Frame: First three hemodialysis sessions (5 days) ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Determine the effect of mannitol administration on the change in blood and urine biomarkers of acute kidney injury during the first three hemodialysis initiation sessions. [ Time Frame: First three hemodialysis sessions (5 days) ] [ Designated as safety issue: No ]

Estimated Enrollment: 200
Study Start Date: May 2012
Estimated Study Completion Date: June 2015
Estimated Primary Completion Date: June 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Placebo group: (0.9% normal saline)
0.9% saline will be administered (IV) during the hemodialysis session at 1.25mL/kg/hour (max 375mLs per session). Administration will be discontinued 30 minutes before the end of the hemodialysis session.
Drug: 0.9% saline
1.25mL/kg/hour; maximum 125mLs/hour; maximum total volume 375mLs per treatment
Active Comparator: Intervention: intravenous mannitol (20%)
Mannitol will be administered (IV) during the hemodialysis session at a maximum rate of 0.25g/kg/hour (maximum rate 25g/hour; maximum 75g per session; maximum volume 375mLs per session). Administration will be discontinued 30 minutes before the end of the hemodialysis session.
Drug: Mannitol (20%)
0.25g/kg/hour (maximum rate 25g/hour; maximum 75g per session; maximum volume 375mLs per session)

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Renal failure requiring intermittent hemodialysis initiation; adult patients aged over 18 years; written informed consent

Exclusion Criteria:

  • Hyponatremia <130 mmol/L; acute myocardial infarction or stroke in previous 7 days; cardiac transplant; ventricular arrhythmia; unstable angina; use of pressors/midodrine; enrollment in conflicting research study; institutionalized individuals; pregnancy; prisoners; documented allergy to mannitol
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01520207

Contacts
Contact: Sushrut S Waikar, MD, MPH 617-732-8473 swaikar@partners.org
Contact: Finnian R Mc Causland, MB, MMSc 617-732-6432 fmccausland@partners.org

Locations
United States, Massachusetts
Brigham and Women's Hospital Recruiting
Boston, Massachusetts, United States, 02115
Principal Investigator: Sushrut S Waikar, MD MPH            
Sponsors and Collaborators
Brigham and Women's Hospital
Investigators
Principal Investigator: Sushrut S Waikar, MD, MPH Brigham and Women's Hospital, Harvard Medical School
Principal Investigator: Finnian R Mc Causland, MB, MMSc Brigham and Women's Hospital
  More Information

No publications provided

Responsible Party: Sushrut S Waikar, Assistant Professor of Medicine, Harvard Medical School, Brigham and Women's Hospital
ClinicalTrials.gov Identifier: NCT01520207     History of Changes
Other Study ID Numbers: NCT01520207
Study First Received: January 25, 2012
Last Updated: February 14, 2013
Health Authority: United States: Partners Institutional Review Board

Additional relevant MeSH terms:
Hypotension
Vascular Diseases
Cardiovascular Diseases
Mannitol
Diuretics, Osmotic
Diuretics
Natriuretic Agents
Physiological Effects of Drugs
Pharmacologic Actions
Cardiovascular Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on June 17, 2013