HaemoDialysis Interventions to REduce Multi-Organ Dysfunction and Effect on Quality of Life Assessed by MRI Scanning

Exclusion Criteria:

• Change in dry weight (clinically defined) in 4 weeks prior to recruitment
• Dialysate composition other than: sodium≥137mmol/L, potassium≥2.0mmol/L, calcium≥1.5mmol/L, magnesium≥0.5mmol/L, glucose 1.0g/L

• Instability on dialysis in 4 weeks prior to recruitment leading to either:

  • Emergency medical attention
  • Infusion of additional fluid
  • Loss in consciousness
  • Arrhythmia
  • Chest pain
  • Or any other medical condition that precludes the scan session in opinion of the investigator
• Dialysed via a synthetic line, central venous catheter or graft
• Qa \< 500ml/min
• NYHA Stage IV heart failure (New York Heart Association)
• Active infection or malignancy
• Contraindication to MRI scanning including claustrophobia, pacemaker, metallic implants etc
• Pregnancy (pregnancy test will be conducted with female patients aged ≤ 55 years) or planning pregnancy or lactation period
• Medical conditions or overall physical frailty precludes scan session in opinion of investigator
• Unable or unwilling to provide informed consent
• Any condition which could interfere with the patient's ability to comply with the study
• Participation in an interventional clinical study during the preceding 30 days

Inclusion Criteria:

• Age 18-80, male and female
• Informed consent signed and dated by study patient and investigator/authorised physician
• Average (4 weeks prior to recruitment) Ultrafiltration volumes ≥ 0.5 litres/ dialysis session
• Receiving dialysis via an arteriovenous fistula
• Must be able to follow simple instruction in English (on safety grounds for MRI scans) and be able to understand the nature and requirements of the study
• Stable dialysis prescription
• CKD5 (Chronic kidney disease) patients having renal replacement therapy with haemodialysis/ haemodiafiltration (>90 days)