Prescription to minimize dialysis-induced ischemia and standardize dialysis discontinuation

Dialysis prescription ordered by their primary nephrologist/intensivist.

Prescription to minimize dialysis-induced ischemia

• Cool dialysate (35.0◦C)

• Dialysate sodium of 145mmol/L

• Dialysate calcium of 1.5mmol/L

• Maximum ultrafiltration rate of 10mL/kg/hour (if no weight, maximum is 500mL/hour)

  • Note: If dialysis machines cannot get to the specified values, values closest to these are acceptable.

Structured dialysis discontinuation (all criteria met)

• Most recent pre-dialysis potassium <6mmo/L and bicarbonate >12mmol/L
• Most recent urine volume ≥1L/day OR last ultrafiltration on dialysis <1L/session
• If available, timed urine collection with result for mean creatinine and/or urea clearance >12mL/min

Recruitment of the target population to the RCT

At least 80% of randomized participants remain in the trial and on the allocated study treatment

The number of days that a patient did not need dialysis. A patient can only accrue dialysis-free days after the final dialysis session that commences the monitoring period for kidney recovery. Participants who die will be considered to have zero dialysis-free days.

Defined as new atrial (excluding sinus tachycardia or sinus arrhythmia) or ventricular arrhythmia that develops during RRT and was not present prior to the initiation of RRT