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Protein-bound Uremic Retention Solutes and Long Nocturnal Hemodialysis: a Longitudinal Analysis

This study has been completed.
Information provided by (Responsible Party):
Björn Meijers, Universitaire Ziekenhuizen Leuven Identifier:
First received: December 28, 2006
Last updated: May 12, 2016
Last verified: May 2016
Study on intradialytic kinetics of protein-bound uremic retention solutes during long nocturnal hemodialysis

Condition Intervention
End Stage Kidney Disease Procedure: hemodialysis

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: A Multicentric Observational Trial on Protein Bound Uremic Toxins in Nocturnal Hemodialysis

Resource links provided by NLM:

Further study details as provided by Björn Meijers, Universitaire Ziekenhuizen Leuven:

Biospecimen Retention:   Samples Without DNA
serum, urine, dialysate

Enrollment: 38
Study Start Date: December 2006
Study Completion Date: December 2014
Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
hemodialysis, 4h, twice weekly
hemodialysis, four hours, twice weekly
Procedure: hemodialysis
hemodialysis, 8h, twice weekly
hemodialysis, eight hours, twice weekly
Procedure: hemodialysis
hemodialysis, 8h, every other day
hemodialysis, eight hours, every other day
Procedure: hemodialysis
hemodialysis, 8h, six days per week
hemodialysis, eight hours, six days per week
Procedure: hemodialysis

Detailed Description:

Although remarkable progress has been made, chronic kidney disease still poses a major burden on both individual patients, as well as on society as a whole. There is a strong inverse relationship between decreasing renal function, as estimated by glomerular filtration rate, and mortality rate, especially death due to cardiovascular disease. The exact cause(s) remain to be elucidated. Uremic toxins might play an important role.

In the course of decreasing renal function the concentration of numerous intracellular and extracellular compounds vary from the non-uremic state. A still increasing number of uremic retention solutes are being identified. Renal replacement strategies aim to remove potentially harmful substances from the body. Traditionally much attention has been paid to small water-soluble molecules such as urea nitrogen and creatinine. Based on the results of the recent HEMO and ADEMEX studies, increases of small water-soluble solute removal above the level reached with modern dialysis techniques (HD, PD) seem not to be advantageous with regard to patient outcome. These findings may point to the importance of other distinct groups of uremic retention solutes. In view of the data described above, protein-bound solutes might be good candidates.

Several advantages of long duration hemodialysis have been observed, including a better control of blood pressure by decreasing extracellular fluid volume, lowering peripheral vascular resistance and improving endothelium-dependent and -independent vasodilation. A normalization of heart rate variability and improvement of left-ventricular function was noted as well. Furthermore, anemia control has been shown to be easier and several nutritional parameters improved in patients treated with long duration HD. The therapy results in higher small water-soluble solute removal, phosphate removal and greater elimination of larger molecules (e.g. β2-microglobulin).

It seems an appealing question whether a better control of the serum levels of protein-bound solutes can be achieved by long duration (nocturnal) hemodialysis. This might be another advantage of this therapeutic modality, or may even in part explain the better outcome of patients treated this way.

The study compares intermittent hemodialysis with long nocturnal hemodialysis with respect to serum concentrations of several protein bound uremic toxins, as well as solute removal.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
maintenance dialysis patients

Inclusion Criteria:

  • Start hemodialysis during 2007
  • Age over 18 years
  • Informed consent

Exclusion Criteria:

  • Non consent
  Contacts and Locations
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Please refer to this study by its identifier: NCT00417339

Australia, Victoria
Monash Medical Centre
Clayton, Victoria, Australia, 3168
Geelong Hospital
Geelong, Victoria, Australia, 3220
Universitaire Ziekenhuizen Leuven
Leuven, Brabant, Belgium, 3000
Virga Jesseziekenhuis
Hasselt, Limburg, Belgium, 3500
Sponsors and Collaborators
Universitaire Ziekenhuizen Leuven
Principal Investigator: Björn KI Meijers, MD Universitaire Ziekenhuizen Leuven
Study Director: Pieter Evenepoel, MD, PhD Universitaire Ziekenhuizen Leuven
Principal Investigator: Tom Dejagere, MD Virga Jesse Ziekenhuis
Principal Investigator: Nigel Toussaint, MD Geelong Hospital
  More Information

Responsible Party: Björn Meijers, Prof, Universitaire Ziekenhuizen Leuven Identifier: NCT00417339     History of Changes
Other Study ID Numbers: NHD002
Study First Received: December 28, 2006
Last Updated: May 12, 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by Björn Meijers, Universitaire Ziekenhuizen Leuven:
dialysis adequacy
uremic retention solute

Additional relevant MeSH terms:
Kidney Diseases
Kidney Failure, Chronic
Renal Insufficiency, Chronic
Urologic Diseases
Renal Insufficiency processed this record on September 21, 2017