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Trial details imported from

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Registration number
Ethics application status
Date submitted
Date registered
Date last updated

Titles & IDs
Public title
Protein-Bound Uremic Retention Solutes in Long Nocturnal Hemodialysis
Scientific title
A Multicentric Observational Study on the Removal of Protein-Bound Uremic Retention Solutes in Nocturnal Hemodialysis: A Cross-Sectional Analysis
Secondary ID [1] 0 0
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
End Stage Renal Disease 0 0
Condition category
Condition code
Renal and Urogenital 0 0 0 0
Kidney disease

Study type
Patient registry
Target follow-up duration
Target follow-up type
Description of intervention(s) / exposure
Treatment: Surgery - hemodialysis
Treatment: Surgery - hemodialysis
Treatment: Surgery - hemodialysis
Treatment: Surgery - hemodialysis

1 - hemodialysis twice weekly 4 hours

2 - nocturnal dialysis twice weekly 8 hours

3 - nocturnal hemodialysis, 8 hours every other night

4 - nocturnal hemodialysis, 8 hours, six times per week

Treatment: Surgery: hemodialysis
group 1: twice weekly, four hours

Treatment: Surgery: hemodialysis
group 2: twice weekly, eight hours

Treatment: Surgery: hemodialysis
group 3: every other day, eight hours

Treatment: Surgery: hemodialysis
group 4: six days a week, eight hours

Intervention code [1] 0 0
Treatment: Surgery
Comparator / control treatment
Control group

Primary outcome [1] 0 0
removal of protein-bound retention solutes
Timepoint [1] 0 0
1 dialysis session

Key inclusion criteria
- Age > 18 years

- Maintenance hemodialysis (> 3 months duration)

- Informed consent
Minimum age
18 Years
Maximum age
No limit
Both males and females
Can healthy volunteers participate?
Key exclusion criteria
- No consent

Study design
Statistical methods / analysis

Recruitment status
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Date of last participant enrolment
Date of last data collection
Sample size
Accrual to date
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Monash Medical Centre - Clayton
Recruitment hospital [2] 0 0
Geelong Hospital - Geelong
Recruitment postcode(s) [1] 0 0
3168 - Clayton
Recruitment postcode(s) [2] 0 0
3220 - Geelong
Recruitment outside Australia
Country [1] 0 0
State/province [1] 0 0
Country [2] 0 0
State/province [2] 0 0

Funding & Sponsors
Primary sponsor type
Universitaire Ziekenhuizen Leuven

Ethics approval
Ethics application status

Brief summary
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. But 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 - hemodialysis, peritoneal dialysis (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. ß2-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.
Trial website
Trial related presentations / publications
Bammens B, Evenepoel P, Keuleers H, Verbeke K, Vanrenterghem Y. Free serum concentrations of the protein-bound retention solute p-cresol predict mortality in hemodialysis patients. Kidney Int. 2006 Mar;69(6):1081-7.
Fagugli RM, De Smet R, Buoncristiani U, Lameire N, Vanholder R. Behavior of non-protein-bound and protein-bound uremic solutes during daily hemodialysis. Am J Kidney Dis. 2002 Aug;40(2):339-47.
Pierratos A. Daily nocturnal home hemodialysis. Kidney Int. 2004 May;65(5):1975-86.
Public notes

Principal investigator
Name 0 0
Björn KI Meijers, MD
Address 0 0
Universitaire Ziekenhuizen Leuven
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications