During hemodialysis treatments, patients receive heparin to prevent clotting. The purpose of this pilot study is to determine if the amount of heparin administered during a patient's hemodialysis can be individualized using an equation for heparin dose adjustment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
5
Patients will begin the study using their currently prescribed heparin doses - both bolus and constant infusion - for three treatments to establish a baseline and provide information on inter-treatment variability in dialyzer clotting. Subsequently, the bolus and infusion rates will be titrated either upward or downward based on the Robbins-Monro process and an evaluation of dialyzer clotting during the preceding treatment. Heparin doses will be adjusted for a total of 30 dialyses.
University of Louisville
Louisville, Kentucky, United States
Change in dialyzer blood compartment volume when the heparin dose is adjusted using a Robbins-Monro algorithm
The objective is to titrate each patient's heparin dose to the level that achieves adequate anticoagulation for that patient as assessed by the change in blood compartment volume of the dialyzer from pre- to post-dialysis. The strategy that will be used is the Robbins-Monro stochastic approximation algorithm.
Time frame: up to 8 weeks
Evaluation of dialyzer performance and visual assessment of clotting in the fiber bundle and the arterial and venous headers
Visual assessment of the dialyzer,measurement of ionic dialysance and ionic Kt/V.
Time frame: up to 8 weeks
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