Shaker Heights doctor finds better use for hemodialysis
Published: Monday, January 10, 2011, 9:15 AM
By Faith Hampton, Sun News
SHAKER HEIGHTS -- A resident and Cleveland Clinic doctor played a big role in discovering a more effective use for hemodialysis.
Dr. Gerald Beck is a Shaker Heights resident and researcher at Cleveland Clinic’s Lerner Research Institute. He was also the head of a data coordinating center for a randomized clinical trial focused on determining whether the frequency of in-center hemodialysis, a treatment to take place of failing kidneys, would be more beneficial if patients went through the treatment six times a week instead of three times a week.
Beck said the National Institute of Health came up with the recommendation to study hemodialysis in a clinical trial. He became involved when Cleveland Clinic’s Lerner Research Institute was chosen to be the data coordinating center.
The trial had two co-primary outcomes.
“Any clinical trial usually has one primary end point in determining a difference in the outcome,” Beck said. “In this trial, nothing could be decided on one end point so it had two outcomes. One is measuring heart health and the size of the heart by measuring the left ventricle and the other was quality of life self-reported by the patient.”
Beck said other information was collected from the trial as well. That information showed some things like cognitive performance, anemia and self-reported depression were not significantly affected by the six times per week treatment. However, the frequent hemodialysis did show a significant improvement in lowering blood pressure and controlling excessive blood phosphate levels, two common issues dialysis patients face.
Beck said with hemodialysis treatment, patients are hooked up to a dialysis machine for several hours a day. The “artificial kidney” can filter out the toxins from a patient’s blood and return cleaner blood back to the patient.
Beck said the six times per week hemodialysis compared to the three times a week treatment was getting patient blood cleaner and keeping it clean for a longer period of time. He said the treatment has been deemed beneficial for patients.
One of the biggest benefits of the trial, which consisted of 245 patients, was the randomization, Beck said.
“With previous observational studies, patients come in and nothing is really controlled. If you randomize patients, with a large enough sample size there is a high probability that factors can be balanced out. All can be controlled so the only thing you are looking for is trying to determine the difference between three times a week and six. It’s a gold standard of research design to be able to control all the factors,” he said.
Beck also worked on a previous NIH sponsored hemodialysis clinical trial completed in 2002. That trial showed increasing the dose of dialysis and size of toxins removed from the blood had no effect on patient health. The 2002 trial create a base for the 2010 study’s premise that the per-session dialysis clearance ability is not as important as continual clearance achieved by increased dialysis frequency.
Dialysis is required for nearly half a million people in the United States and two million people worldwide for those with kidney failure.
http://blog.cleveland.com/sunpress/2011/01/shaker_heights_doctor_finds_be.html
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