Sodium fOr diaLysis oUTcome rEduction
Maintenance of blood pressure in persons on hemodialysis is vital, but can be very difficult. Sodium intake reduction is a cornerstone of blood pressure management in this population. A potential solution is the modification of sodium concentration in dialysate, and 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.
PI: Dr. Conor Judge
Dr. Conor Judge is a recently graduated consultant nephrologist at the Galway University Hospital in Ireland. He graduated from his PhD with the Irish Clinical Academic Training (ICAT) programme in June 2022 and completed a fellowship in general nephrology in McMaster University, Ontario, Canada (2020-2022). His PhD “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.
Prior to medicine, he trained as an electronic and computer engineer and has a passion for combining data analytics with medicine. As a trainee, Dr. Judge created two electronic health record databases in Galway University Hospital which have been used for over 100,000 patients over the last 6 years. He is currently researching using deep neural networks for decision support systems in Hypertension and 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.