Exploring Water-free Sodium Storage
Yale University
Summary
The overarching goal of this proposal is to definitively establish if acute water free Na storage and release occurs, if the amount stored/released is of a quantity that is physiologically relevant, and if the location is intracellular vs. extracellular.
Description
This study is designed as a an ultra-rigorous inpatient balance study. The main purpose of the study is to determine if significant mobilizable non- extracellular volume (ECV) Na storage occurs in humans. This is a randomized, blinded crossover study. Patients will be randomized to Na free 5% dextrose solution or 1.5% standard peritoneal dialysis (PD) fluid (Dianeal 1.5% low calcium PD solution with standard 132 mmol/L Na and osmolarity of 344 mOsmol/L) and will receive treatment for 5 days, following a 6 week wash out patient will return to undergo 5 days of alternate therapy.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * ESRD Patients actively undergoing PD with a reliably functioning PD catheter * Systolic blood pressure \> 130 mmHg * Serum sodium \>135 mmol/L * daily urine output \< 400ml * stable PD prescription for at least 2 months without requirement of 4.25% glucose PD solution * PD vintage of at least 6 months * Euvolemic as defined by the patient at their dry weight and free of any signs or symptoms of volume overload, per referring nephrologist Exclusion Criteria: * Poorly controlled diabetes with hemoglobin A1C\>9% * 1 or more episodes of peritonitis in the previous 6 months…
Interventions
- Drug5% Dextrose/Water
Patients will be randomized to undergo up to two-hour dwell with 5% dextrose in sterile water for 5 days
- Drug1.5% standard PD fluid
Patients will be randomized to undergo up to two-hour dwell with 1.5% standard PD fluid for 5 days
Location
- Yale UniversityNew Haven, Connecticut