This study evaluates the effect of high-flux hemodialysis compared to hemodiafiltration on small and moderate molecule substances clearance. Meanwhile, this study evaluates the effect of high-flux hemodialysis compared to hemodiafiltration on cardiac function. In this self matching study, participants will receive high-flux hemodialysis compared to hemodiafiltration.

Hemodialysis using diffusion, ultrafiltration and convection principle to remove harmful substances in the blood and excessive water, is one of the most commonly replacement therapy.

Hemodiafiltration is a combination of hemodialysis and hemofiltration with two modes of treatment advantages, both by diffusion and convection principle to remove harmful substances in the blood.

Inclusion Criteria:

1. Subject has end-stage renal disease.
2. Subject has been on regular dialysis treatment for at least 6 months.
3. Subject has autologous vascular access.
4. Subject is offered thrice weekly hemodialysis.
5. Subject is offered 4 hours duration hemodialysis.

Exclusion Criteria:

1. Infectious disease
2. Poor echocardiographic window that was unsuitable for interpretation

Supporting Information: study protocol, statistic analysis plan, informed consent form, clinical study report.

Time Frame: Data will be available within 1 year of study completion. Access Criteria: Data access requests will be reviewed by an external Independent Review panel. Requestors will be required to sign a Data Access Agreement.