SOLUTE Trial
Sodium fOr diaLysis oUTcome rEduction
Persons on hemodialysis have a hard time maintaining their blood pressure. Sodium intake reduction is a cornerstone of blood pressure management in the hemodialysis population. A potential solution is the modification of sodium concentration in dialysate. Observational studies have shown a positive association between lower dialysate sodium concentration and lower blood pressure, lower interdialytic weight gain and lower anti-hypertensive medication use. One previous study showed no different in primary outcome of left ventricular mass index, despite differences in interdialytic weight gain.
RESOLVE, a separate pragmatic cluster randomized trial that will compare the effectiveness of two fixed dialysate sodium concentrations (137 mmol/L vs 140 mmol/L). Dr. Conor Judge proposed a cluster randomized controlled trial comparing zero sodium gradient (0 mmol/L) (which is dialysate sodium minus pre-dialysate plastma sodium results) with a fixed dialysate sodium of 138 mmol/L. This would essentially personalize the sodium concentration to the patient. The trial will evaluate the effectiveness on the primary outcome of cardiovascular events.
Presentation Slides
PI: Dr. Conor Judge
Dr. Conor Judge recently graduated from the Galway University Hospital in Ireland as a consultant nephrologist. In June 2022, he graduated from his PhD with the Irish Clinical Academic Training (ICAT) programme and completed a fellowship in general nephrology in McMaster University, Ontario, Canada (2020-2022). His thesis, “Adaptive Clinical Trials of Sodium Lowering in Chronic Kidney Disease and Dialysis: Analytic and Methodologic Challenges” was completed in the HRB Clinical Research Facility Galway and the Translational Medical Device lab.
He trained as an electronic and computer engineer before he moved to medicine. Because of this, he has a passion for combining data analytics with medicine. As a trainee, Dr. Judge created two electronic health record databases in Galway University Hospital. Over the past six years, these databases been used for over 100,000 patients. His current research focuses on using deep neural networks for decision support systems in Hypertension. He’s also developing a new MSc in Applied Clinical Data Analytics at the University of Galway to teach healthcare workers research methodology, coding and health data analytics.