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Adding Urea to the Final Dialysis Fluid

Adding Urea to the Final Dialysis Fluid in Order to Prevent Dialysis Disequilibrium in Patients Who Need Aggressive Dialysis for Electrolyte Abnormalities

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

* Serum Urea \> 120
* Serum Potassium \> 5.5 or serum CO2 \< 15 or need for aggressive dialysis due to toxic ingestion
* need for dialysis

Exclusion Criteria:

* Pediatric
* need for CRRT

About the study

At times patients with advanced renal failure present with severe hyperkalemia or acidosis and very high serum blood urea nitrogen (BUN) concentrations. These patients cannot be dialyzed aggressively as the lowering of serum BUN may results in disequilibrium syndrome but on the other hand they need aggressive dialysis in order to lower their serum potassium or fix their severe acidosis. If one is able to add urea to the dialysis fluid, one can prevent the rapid lowering of serum BUN and osmolality at the same time as doing aggressive dialysis to lower serum potassium and/or fix the metabolic acidosis.

What is being tested

• Urea in the dialysate (drug)

Sponsor: University of California, San Francisco · Participants: 20 · Started: Sep 16, 2025

Contact the study team

• Ramin Sam, MD · Phone: 6282066605

Official record on ClinicalTrials.gov — NCT06366230

Locations in the U.S.

Conditions

• Kidney Failure
• Acidosis

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.