Mechanisms of Intradialytic Hypertension

Completed · Not applicable

Conditions studied: Renal Failure Chronic Requiring Hemodialysis, Haemodialysis-induced Symptom, Hypertension

In brief

Patients with end-stage renal disease (ESRD) are at significantly higher risk for death due to cardiovascular disease. Those with paradoxical increases in blood pressure (BP) during hemodialysis (HD), defined as intradialytic hypertension (IDH), are at even greater risk of cardiovascular mortality. This study seeks to determine the mechanisms that underlie IDH, and whether mindfulness meditation might improve BP during dialysis in these patients. The investigators will first determine if increased adrenaline levels during volume removal contributes to IDH. The investigators will then determine lack of suppression of adrenaline levels in the setting of a high BP also contributes to IDH. This will be done by manipulating blood pressure by using small amounts of vasoactive drugs, and determining if an appropriate response in adrenaline levels occurs. Lastly, the investigators will determine if an intradialytic mindfulness meditation program improves BP and adrenaline levels in ESRD patients with IDH.

Key facts

Study ID

NCT01947673

Run by

Emory University

People needed

49

Starts

2013-09-01

Expected to finish

2017-11-01

Last updated by the study team

2021-07-15

Who can join

Age: 18 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• ESRD patients on maintenance hemodialysis for at least 6 months, with increased blood pressure during hemodialysis

You may not qualify if…

• drug or alcohol abuse
• any serious systemic disease that might influence survival
• severe anemia with hgb level <8 g/dL
• clinical evidence of congestive heart failure
• ejection fraction below 35%
• myocardial infarction or cerebrovascular accident within the past six months
• symptomatic heart disease determined by electrocardiogram, stress test, and/or history
• treatment with central alpha agonists or monoamine oxidase (MAO) inhibitors
• peripheral neuropathy
• autonomic dysfunction
• pregnancy
• surgery within the past 3 months

Where it is running

• Emory Dialysis Clinics — Atlanta, Georgia, United States

Full record on ClinicalTrials.gov

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