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出境医 / 临床实验 / Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease: HEBE-CKD Trial

Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease: HEBE-CKD Trial

Study Description
Brief Summary:

This study aims to demonstrate the possible benefit of a treatment based on double diuretic in patients with chronic kidney disease and severely impaired glomerular filtration rate. This is based on previous observations where the investigators found that volume overload is a frequent condition within this population and is strongly linked to an increase in morbidity and mortality. The investigators consider that this therapy could be beneficial given that most of these patients are treated with loop diuretics, however, with the passage of time, adaptive changes in the distal nephron occur that promote a decrease in the treatment effect. In this sense, thiazide diuretics at appropriate doses could 'break' the resistance, since their mechanism of action antagonizes the resistance mechanism. Unfortunately, to this day, this treatment has not been fully evaluated. Particularly in this type of population.

The investigators developed a study proposed as a double blind randomized clinical trial, where the population will be divided into two groups. A group will be given the standard treatment based on loop diuretic (bumetanide), while the other group will receive the intervention (bumetanide plus chlorthalidone). After a 30-day follow-up period, the results will be measured.

With respect to the effectiveness of the treatment, the decrease in volume overload by bioimpedance will be measured. While the occurrence of adverse effects during the same monitoring period will be observed.


Condition or disease Intervention/treatment Phase
Renal Insufficiency, Chronic Drug: Chlorthalidone Drug: Bumetanide Phase 2

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 34 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease: HEBE-CKD Trial
Actual Study Start Date : June 18, 2019
Actual Primary Completion Date : October 28, 2019
Actual Study Completion Date : October 28, 2019
Arms and Interventions
Arm Intervention/treatment
Placebo Comparator: Placebo
This group will receive 3 milligrams of bumetanide per day for a week plus placebo (starch) that will simulate the chlorthalidone dose of the treatment group. In case the dose is well tolerated, the dose of bumetanide will be increased to 4 milligrams per day.
 Drug: Bumetanide
Bumetanide
Experimental: Treatment grup
This group will receive 3 milligrams of bumetanide plus 50 milligrams of chlorthalidone per day, for a week. If the dose is well tolerated, it will be increased to 4 milligrams of bumetanide and 100 milligrams of chlorthalidone per day.
 Drug: Chlorthalidone
Chlorthalidone

Drug: Bumetanide
Bumetanide
Outcome Measures
Primary Outcome Measures :
  1. Change in Total Body Water [ Time Frame: Change from Basal to day 28 ]
    Measured by bioelectrical impedance analysis, compared to the initial measurement


Secondary Outcome Measures :
  1. Change in Mean Arterial Pressure [ Time Frame: Change from Basal to day 28 ]
    decrease in blood pressure compared wit baseline measure (mmhg)

  2. Change in the Fractional Excretion of Sodium [ Time Frame: Change from Basal to day 28 ]
    Increase in the fractional excretion of sodium compared with the baseline measure

  3. Change in Extracellular Water [ Time Frame: Change from Basal to day 28 ]
    Decrease in extracellular water measured by bioelectrical impedance analysis

  4. Change in Extracellular Water / Total Body Water Ratio [ Time Frame: Change from Basal to day 28 ]
    Decrease in extracellular water / total body water ratio measured by bioelectrical impedance analysis

  5. Change in Systolic Blood Pressure [ Time Frame: Change from Basal to day 28 ]
  6. Change in Diastolic Blood Pressure [ Time Frame: Change from Basal to day 28 ]

Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • glomerular filtration rate less than 30 ml / min / 1.73m
  • Without replacement therapy (dialysis or hemodialysis)
  • Volume overload
  • At least 100 ml per day of residual diuresis
  • Use of a loop diuretic for at least one month

Exclusion Criteria:

  • Allergies known to diuretics
  • Patients with severe infections
  • Patients with hemodynamic instability
  • Amputees
  • Patients with cognitive impairment
  • Patients with acute renal failure
  • Patients with graft loss
Contacts and Locations

Locations
Layout table for location information
Mexico
Hospital General de Mexico
Mexico City, Mexico, 06720
Sponsors and Collaborators
Hospital General de México Dr. Eduardo Liceaga
Investigators
Layout table for investigator information
Principal Investigator: Fabio Solis-Jimenez, M.D. Hospital General de México Dr. Eduardo Liceaga
Tracking Information
First Submitted Date  ICMJE April 18, 2019
First Posted Date  ICMJE April 23, 2019
Results First Submitted Date  ICMJE February 5, 2020
Results First Posted Date  ICMJE March 10, 2020
Last Update Posted Date November 23, 2020
Actual Study Start Date  ICMJE June 18, 2019
Actual Primary Completion Date October 28, 2019   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: November 4, 2020) 		Change in Total Body Water [ Time Frame: Change from Basal to day 28 ]
Measured by bioelectrical impedance analysis, compared to the initial measurement
Original Primary Outcome Measures  ICMJE
 (submitted: April 22, 2019)
  • Decrease in volume overload [ Time Frame: 30 days ]
    Measured by bioimpedance, compared to the initial measurement
  • Adverse Events [ Time Frame: 30 days ]
    frequency of adverse events (hypokalemia, hyperuricemia, hyponatremia, etc.)
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: November 4, 2020)
  • Change in Mean Arterial Pressure [ Time Frame: Change from Basal to day 28 ]
    decrease in blood pressure compared wit baseline measure (mmhg)
  • Change in the Fractional Excretion of Sodium [ Time Frame: Change from Basal to day 28 ]
    Increase in the fractional excretion of sodium compared with the baseline measure
  • Change in Extracellular Water [ Time Frame: Change from Basal to day 28 ]
    Decrease in extracellular water measured by bioelectrical impedance analysis
  • Change in Extracellular Water / Total Body Water Ratio [ Time Frame: Change from Basal to day 28 ]
    Decrease in extracellular water / total body water ratio measured by bioelectrical impedance analysis
  • Change in Systolic Blood Pressure [ Time Frame: Change from Basal to day 28 ]
  • Change in Diastolic Blood Pressure [ Time Frame: Change from Basal to day 28 ]
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease: HEBE-CKD Trial
Official Title  ICMJE Chlortalidone and Bumetanide in Advanced Chronic Kidney Disease: HEBE-CKD Trial
Brief Summary

This study aims to demonstrate the possible benefit of a treatment based on double diuretic in patients with chronic kidney disease and severely impaired glomerular filtration rate. This is based on previous observations where the investigators found that volume overload is a frequent condition within this population and is strongly linked to an increase in morbidity and mortality. The investigators consider that this therapy could be beneficial given that most of these patients are treated with loop diuretics, however, with the passage of time, adaptive changes in the distal nephron occur that promote a decrease in the treatment effect. In this sense, thiazide diuretics at appropriate doses could 'break' the resistance, since their mechanism of action antagonizes the resistance mechanism. Unfortunately, to this day, this treatment has not been fully evaluated. Particularly in this type of population.

The investigators developed a study proposed as a double blind randomized clinical trial, where the population will be divided into two groups. A group will be given the standard treatment based on loop diuretic (bumetanide), while the other group will receive the intervention (bumetanide plus chlorthalidone). After a 30-day follow-up period, the results will be measured.

With respect to the effectiveness of the treatment, the decrease in volume overload by bioimpedance will be measured. While the occurrence of adverse effects during the same monitoring period will be observed.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Condition  ICMJE Renal Insufficiency, Chronic
Intervention  ICMJE
  • Drug: Chlorthalidone
    Chlorthalidone
  • Drug: Bumetanide
    Bumetanide
Study Arms  ICMJE
  • Placebo Comparator: Placebo
    This group will receive 3 milligrams of bumetanide per day for a week plus placebo (starch) that will simulate the chlorthalidone dose of the treatment group. In case the dose is well tolerated, the dose of bumetanide will be increased to 4 milligrams per day.
    Intervention: Drug: Bumetanide
  • Experimental: Treatment grup
    This group will receive 3 milligrams of bumetanide plus 50 milligrams of chlorthalidone per day, for a week. If the dose is well tolerated, it will be increased to 4 milligrams of bumetanide and 100 milligrams of chlorthalidone per day.
    Interventions:
    • Drug: Chlorthalidone
    • Drug: Bumetanide
Publications *
  • Bello AK, Levin A, Tonelli M, Okpechi IG, Feehally J, Harris D, Jindal K, Salako BL, Rateb A, Osman MA, Qarni B, Saad S, Lunney M, Wiebe N, Ye F, Johnson DW. Assessment of Global Kidney Health Care Status. JAMA. 2017 May 9;317(18):1864-1881. doi: 10.1001/jama.2017.4046.
  • Neuen BL, Chadban SJ, Demaio AR, Johnson DW, Perkovic V. Chronic kidney disease and the global NCDs agenda. BMJ Glob Health. 2017 Jul 6;2(2):e000380. doi: 10.1136/bmjgh-2017-000380. eCollection 2017.
  • Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012 Jan 14;379(9811):165-80. doi: 10.1016/S0140-6736(11)60178-5. Epub 2011 Aug 15. Review.
  • van de Luijtgaarden MW, Noordzij M, van Biesen W, Couchoud C, Cancarini G, Bos WJ, Dekker FW, Gorriz JL, Iatrou C, Wanner C, Finne P, Stojceva-Taneva O, Cala S, Stel VS, Tomson C, Jager KJ. Conservative care in Europe--nephrologists' experience with the decision not to start renal replacement therapy. Nephrol Dial Transplant. 2013 Oct;28(10):2604-12. doi: 10.1093/ndt/gft287. Epub 2013 Sep 7.
  • Morton RL, Turner RM, Howard K, Snelling P, Webster AC. Patients who plan for conservative care rather than dialysis: a national observational study in Australia. Am J Kidney Dis. 2012 Mar;59(3):419-27. doi: 10.1053/j.ajkd.2011.08.024. Epub 2011 Oct 20.
  • Wong SP, Hebert PL, Laundry RJ, Hammond KW, Liu CF, Burrows NR, O'Hare AM. Decisions about Renal Replacement Therapy in Patients with Advanced Kidney Disease in the US Department of Veterans Affairs, 2000-2011. Clin J Am Soc Nephrol. 2016 Oct 7;11(10):1825-1833. doi: 10.2215/CJN.03760416. Epub 2016 Sep 22.
  • Davison SN, Levin A, Moss AH, Jha V, Brown EA, Brennan F, Murtagh FE, Naicker S, Germain MJ, O'Donoghue DJ, Morton RL, Obrador GT; Kidney Disease: Improving Global Outcomes. Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care. Kidney Int. 2015 Sep;88(3):447-59. doi: 10.1038/ki.2015.110. Epub 2015 Apr 29.
  • Verberne WR, Dijkers J, Kelder JC, Geers ABM, Jellema WT, Vincent HH, van Delden JJM, Bos WJW. Value-based evaluation of dialysis versus conservative care in older patients with advanced chronic kidney disease: a cohort study. BMC Nephrol. 2018 Aug 16;19(1):205. doi: 10.1186/s12882-018-1004-4.
  • Murtagh FE, Addington-Hall JM, Edmonds PM, Donohoe P, Carey I, Jenkins K, Higginson IJ. Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis. J Palliat Med. 2007 Dec;10(6):1266-76.
  • Thomas R, Kanso A, Sedor JR. Chronic kidney disease and its complications. Prim Care. 2008 Jun;35(2):329-44, vii. doi: 10.1016/j.pop.2008.01.008. Review.
  • Hung SC, Lai YS, Kuo KL, Tarng DC. Volume overload and adverse outcomes in chronic kidney disease: clinical observational and animal studies. J Am Heart Assoc. 2015 May 5;4(5). pii: e001918. doi: 10.1161/JAHA.115.001918.
  • Titze J. Interstitial fluid homeostasis and pressure: news from the black box. Kidney Int. 2013 Nov;84(5):869-71. doi: 10.1038/ki.2013.287.
  • Yatime L, Laursen M, Morth JP, Esmann M, Nissen P, Fedosova NU. Structural insights into the high affinity binding of cardiotonic steroids to the Na+,K+-ATPase. J Struct Biol. 2011 May;174(2):296-306. doi: 10.1016/j.jsb.2010.12.004. Epub 2010 Dec 21.
  • Khalaf FK, Dube P, Mohamed A, Tian J, Malhotra D, Haller ST, Kennedy DJ. Cardiotonic Steroids and the Sodium Trade Balance: New Insights into Trade-Off Mechanisms Mediated by the Na⁺/K⁺-ATPase. Int J Mol Sci. 2018 Aug 30;19(9). pii: E2576. doi: 10.3390/ijms19092576. Review.
  • Akchurin OM, Kaskel F. Update on inflammation in chronic kidney disease. Blood Purif. 2015;39(1-3):84-92. doi: 10.1159/000368940. Epub 2015 Jan 20. Review.
  • Maruta Y, Hasegawa T, Yamakoshi E, Nishiwaki H, Koiwa F, Imai E, Hishida A. Association between serum Na-Cl level and renal function decline in chronic kidney disease: results from the chronic kidney disease Japan cohort (CKD-JAC) study. Clin Exp Nephrol. 2019 Feb;23(2):215-222. doi: 10.1007/s10157-018-1631-x. Epub 2018 Aug 24.
  • Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH. Chronic Kidney Disease, Fluid Overload and Diuretics: A Complicated Triangle. PLoS One. 2016 Jul 21;11(7):e0159335. doi: 10.1371/journal.pone.0159335. eCollection 2016.
  • Arikan AA, Zappitelli M, Goldstein SL, Naipaul A, Jefferson LS, Loftis LL. Fluid overload is associated with impaired oxygenation and morbidity in critically ill children. Pediatr Crit Care Med. 2012 May;13(3):253-8. doi: 10.1097/PCC.0b013e31822882a3.
  • Hassinger AB, Wald EL, Goodman DM. Early postoperative fluid overload precedes acute kidney injury and is associated with higher morbidity in pediatric cardiac surgery patients. Pediatr Crit Care Med. 2014 Feb;15(2):131-8. doi: 10.1097/PCC.0000000000000043.
  • Magee G, Zbrozek A. Fluid overload is associated with increases in length of stay and hospital costs: pooled analysis of data from more than 600 US hospitals. Clinicoecon Outcomes Res. 2013 Jun 26;5:289-96. doi: 10.2147/CEOR.S45873. Print 2013.
  • Vaara ST, Korhonen AM, Kaukonen KM, Nisula S, Inkinen O, Hoppu S, Laurila JJ, Mildh L, Reinikainen M, Lund V, Parviainen I, Pettilä V; FINNAKI Study Group. Fluid overload is associated with an increased risk for 90-day mortality in critically ill patients with renal replacement therapy: data from the prospective FINNAKI study. Crit Care. 2012 Oct 17;16(5):R197. doi: 10.1186/cc11682.
  • Di Lullo L, Gorini A, Russo D, Santoboni A, Ronco C. Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment. Cardiorenal Med. 2015 Oct;5(4):254-66. doi: 10.1159/000435838. Epub 2015 Jul 15. Review.
  • Ekinci C, Karabork M, Siriopol D, Dincer N, Covic A, Kanbay M. Effects of Volume Overload and Current Techniques for the Assessment of Fluid Status in Patients with Renal Disease. Blood Purif. 2018;46(1):34-47. doi: 10.1159/000487702. Epub 2018 Apr 12. Review.
  • Collins AJ, Foley RN, Gilbertson DT, Chen SC. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011). 2015 Jun;5(1):2-7.
  • Chang ST, Chen CL, Chen CC, Lin FC, Wu D. Enhancement of quality of life with adjustment of dry weight by echocardiographic measurement of inferior vena cava diameter in patients undergoing chronic hemodialysis. Nephron Clin Pract. 2004;97(3):c90-7.
  • Andreucci M, Russo D, Fuiano G, Minutolo R, Andreucci VE. Diuretics in renal failure. Miner Electrolyte Metab. 1999 Jan-Apr;25(1-2):32-8. Review.
  • Wilcox CS. New insights into diuretic use in patients with chronic renal disease. J Am Soc Nephrol. 2002 Mar;13(3):798-805. doi: 10.1681/ASN.V133798. Review.
  • National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266.
  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72. Epub 2003 May 14. Erratum in: JAMA. 2003 Jul 9;290(2):197.
  • Roberts MA. Commentary on the KDIGO Clinical Practice Guideline for the management of blood pressure in chronic kidney disease. Nephrology (Carlton). 2014 Jan;19(1):53-5. doi: 10.1111/nep.12168.
  • James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-20. doi: 10.1001/jama.2013.284427. Erratum in: JAMA. 2014 May 7;311(17):1809.
  • Hoorn EJ, Ellison DH. Diuretic Resistance. Am J Kidney Dis. 2017 Jan;69(1):136-142. doi: 10.1053/j.ajkd.2016.08.027. Epub 2016 Nov 1. Review.
  • Bowman BN, Nawarskas JJ, Anderson JR. Treating Diuretic Resistance: An Overview. Cardiol Rev. 2016 Sep-Oct;24(5):256-60. doi: 10.1097/CRD.0000000000000116. Review.
  • Ellison DH, Felker GM. Diuretic Treatment in Heart Failure. N Engl J Med. 2017 Nov 16;377(20):1964-1975. doi: 10.1056/NEJMra1703100. Review. Erratum in: N Engl J Med. 2018 Feb 1;378(5):492.
  • Knepper MA. Systems biology of diuretic resistance. J Clin Invest. 2015 May;125(5):1793-5. doi: 10.1172/JCI81505. Epub 2015 Apr 20.
  • Shahin MH, Johnson JA. Mechanisms and pharmacogenetic signals underlying thiazide diuretics blood pressure response. Curr Opin Pharmacol. 2016 Apr;27:31-7. doi: 10.1016/j.coph.2016.01.005. Epub 2016 Feb 10. Review.
  • Yugar LBT, Moreno B, Moreno H, Vilela-Martin JF, Yugar-Toledo JC. Do thiazide diuretics reduce central systolic blood pressure in hypertension? J Clin Hypertens (Greenwich). 2018 Jan;20(1):133-135. doi: 10.1111/jch.13134. Epub 2017 Nov 6.
  • REUBI FC, COTTIER PT. Effects of reduced glomerular filtration rate on responsiveness to chlorothiazide and mercurial diuretics. Circulation. 1961 Feb;23:200-10.
  • Bennett WM, Porter GA. Efficacy and safety of metolazone in renal failure and the nephrotic syndrome. J Clin Pharmacol. 1973 Aug-Sep;13(8):357-64.
  • Dargie HJ, Allison ME, Kennedy AC, Gray MJ. High dosage metolazone in chronic renal failure. Br Med J. 1972 Oct 28;4(5834):196-8.
  • Craswell PW, Ezzat E, Kopstein J, Varghese Z, Moorhead JF. Use of metolazone, a new diuretic, in patients with renal disease. Nephron. 1974;12(1):63-73.
  • Dargie HJ, Allison ME, Kennedy AC, Gray MJ. Efficacy of metolazone in patients with renal edema. Clin Nephrol. 1974;2(4):157-60.
  • Wollam GL, Tarazi RC, Bravo EL, Dustan HP. Diuretic potency of combined hydrochlorothiazide and furosemide therapy in patients with azotemia. Am J Med. 1982 Jun;72(6):929-38.
  • Fliser D, Schröter M, Neubeck M, Ritz E. Coadministration of thiazides increases the efficacy of loop diuretics even in patients with advanced renal failure. Kidney Int. 1994 Aug;46(2):482-8.
  • Knauf H, Mutschler E. Diuretic effectiveness of hydrochlorothiazide and furosemide alone and in combination in chronic renal failure. J Cardiovasc Pharmacol. 1995 Sep;26(3):394-400.
  • Dussol B, Moussi-Frances J, Morange S, Somma-Delpero C, Mundler O, Berland Y. A randomized trial of furosemide vs hydrochlorothiazide in patients with chronic renal failure and hypertension. Nephrol Dial Transplant. 2005 Feb;20(2):349-53. Epub 2004 Dec 22.
  • Dussol B, Moussi-Frances J, Morange S, Somma-Delpero C, Mundler O, Berland Y. A pilot study comparing furosemide and hydrochlorothiazide in patients with hypertension and stage 4 or 5 chronic kidney disease. J Clin Hypertens (Greenwich). 2012 Jan;14(1):32-7. doi: 10.1111/j.1751-7176.2011.00564.x. Epub 2011 Dec 9.
  • Agarwal R, Sinha AD, Pappas MK, Ammous F. Chlorthalidone for poorly controlled hypertension in chronic kidney disease: an interventional pilot study. Am J Nephrol. 2014;39(2):171-82. doi: 10.1159/000358603. Epub 2014 Feb 11.
  • Cirillo M, Marcarelli F, Mele AA, Romano M, Lombardi C, Bilancio G. Parallel-group 8-week study on chlorthalidone effects in hypertensives with low kidney function. Hypertension. 2014 Apr;63(4):692-7. doi: 10.1161/HYPERTENSIONAHA.113.02793. Epub 2014 Jan 6.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: March 2, 2020) 		34
Original Estimated Enrollment  ICMJE
 (submitted: April 22, 2019) 		40
Actual Study Completion Date  ICMJE October 28, 2019
Actual Primary Completion Date October 28, 2019   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • glomerular filtration rate less than 30 ml / min / 1.73m
  • Without replacement therapy (dialysis or hemodialysis)
  • Volume overload
  • At least 100 ml per day of residual diuresis
  • Use of a loop diuretic for at least one month

Exclusion Criteria:

  • Allergies known to diuretics
  • Patients with severe infections
  • Patients with hemodynamic instability
  • Amputees
  • Patients with cognitive impairment
  • Patients with acute renal failure
  • Patients with graft loss
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Mexico
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03923933
Other Study ID Numbers  ICMJE DI/19/105-B/03/018
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Fabio Solis-Jimenez, Hospital General de México Dr. Eduardo Liceaga
Study Sponsor  ICMJE Hospital General de México Dr. Eduardo Liceaga
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Fabio Solis-Jimenez, M.D. Hospital General de México Dr. Eduardo Liceaga
PRS Account Hospital General de México Dr. Eduardo Liceaga
Verification Date November 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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