A randomised controlled crossover trial of biofeedback control of end-dialysis plasma conductivity versus progressive reduction of dialysate conductivity.

INTERVENTION: We propose to randomise patients to serial reduction of fixed dialysate conductivity or to reduction of end‐dialysis plasma conductivity achieved using a biofeedback loop (Diacontrol). Diacontrol monitors plasma conductivity and adjusts dialysate conductivity to achieve a prescribed end‐dialysis plasma conductivity. This should deliver a specific end‐dialysis total body sodium, thus automatically adjusting for variation in interdialytic kietary sodium intake. Haemodynamic stability on dialysis should be improved with this technique, allowing more patients to reap the benefits of low dialysate conductivity. Two groups of patients will have either Diacontrol or fixed dialysate conductivity. After serial reduction, the groups will cross over to the other modality. At the end of the trial all patients will revert to the unit standard dialysate of 13.6 mS/cm. CONDITION: Urological and Genital Diseases: Renal ; Urological and Genital Diseases ; Renal PRIMARY OUTCOME: 1. End‐dialysis plasma conductivity; 2. Numbers of patients achieving each reduction; 3. Haemodynamic stability, assessed using a variety of measures SECONDARY OUTCOME: Not provided at time of registration INCLUSION CRITERIA: Chronic haemodialysis patients