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Sponsors and Collaborators: |
Barnes-Jewish Hospital Foundation National Kidney Foundation |
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Information provided by: | Barnes-Jewish Hospital Foundation |
ClinicalTrials.gov Identifier: | NCT00575484 |
At present the standard management of fluid overload in patients with congestive heart failure (CHF) involves limiting the intake of salt and water while administering high dose diuretics, often at the cost of deteriorating kidney function. However, another group of researchers has previously shown that intravenously infusing small volumes of concentrated saline during diuretic dosing and liberalizing dietary salt intake while continuing to limit water consumption resulted in improved fluid removal in CHF patients. Furthermore, less deterioration in kidney function, shorter hospitalizations, reduced readmission rates, and even reduced mortality were observed.
The present study will examine this novel therapy in a population of 60 patients with underlying severe CHF and kidney dysfunction hospitalized for the management of fluid overload. Half of these patients will receive investigational treatment with concentrated salt infusions and liberalized salt consumption during diuretic therapy. All patients will otherwise receive the standard therapies for heart failure, including restrictions on water consumption. This study will attempt to verify the improvements in clinical endpoints previously described and define the mechanisms of enhanced fluid removal.
Condition | Intervention | Phase |
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Congestive Heart Failure Renal Insufficiency |
Drug: Hypertonic saline, then oral sodium chloride Drug: Normal saline, then oral placebo capsule |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Parallel Assignment, Efficacy Study |
Official Title: | Hypertonic Saline With Furosemide and a Normosodic Diet for the Treatment of Decompensated Congestive Heart Failure With Prerenal Physiology |
Estimated Enrollment: | 60 |
Study Start Date: | November 2007 |
Estimated Study Completion Date: | July 2010 |
Estimated Primary Completion Date: | July 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Placebo Comparator |
Drug: Normal saline, then oral placebo capsule
20mL normal saline infusion X 30min BID dosed simultaneously with IV bolus furosemide BID (latter dose per treating physician) PLUS 2gm sodium diet PLUS 1.5L fluid restriction. After switch to oral diuretic, begin oral placebo capsule BID, dosed with loop diuretic (dose per treating physician) PLUS 2gm sodium diet PLUS 1.5L fluid restriction.
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2: Active Comparator |
Drug: Hypertonic saline, then oral sodium chloride
2mL/kg hypertonic saline (4.4% NaCl if serum sodium </=135, else 2.8% NaCl) infused over 30min BID and dosed simultaneously with IV bolus furosemide BID (latter dose per treating physician) until patient is switched to oral loop diuretic. After switch to oral diuretic, subject will receive oral 0.75gm sodium (NaCL) capsule dosed BID with loop diuretic (latter dose per treating physician) until 60d after discharge.
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Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, Missouri | |
Barnes-Jewish Hospital; Washington University School of Medicine | |
Saint Louis, Missouri, United States, 63110 |
Principal Investigator: | Anitha Vijayan, M.D. | Renal Division, Washington University School of Medicine |
Principal Investigator: | Kamalanathan K Sambandam, M.D. | Renal Division, Washington University School of Medicine |
Principal Investigator: | Gregory A Ewald, M.D. | Cardiovascular Division, Washington University School of Medicine |
Responsible Party: | Washington University School of Medicine ( Anitha Vijayan, Associate Professor of Medicine ) |
Study ID Numbers: | 00904-0407-01 |
Study First Received: | December 17, 2007 |
Last Updated: | September 2, 2009 |
ClinicalTrials.gov Identifier: | NCT00575484 History of Changes |
Health Authority: | United States: Institutional Review Board |
Congestive Heart Failure Renal Insufficiency Hypertonic Saline Solution Diuretic Resistance Cardiorenal Syndrome |
Heart Failure Renal Insufficiency Heart Diseases Urologic Diseases |
Diuretics Kidney Diseases Furosemide |
Renal Insufficiency Heart Failure Heart Diseases Urologic Diseases Natriuretic Agents |
Physiological Effects of Drugs Diuretics Cardiovascular Diseases Kidney Diseases Pharmacologic Actions |