The Reducing Adverse Outcomes in Dialysis by Adjusting the pRescription for Dialysate Potassium Trial

The Reducing Adverse Outcomes in Dialysis by Adjusting the pRescription for Dialysate Potassium Trial (RADAR-K): A Randomized, Controlled, Pilot Trial Comparing Usual Care to a Precision Approach to Dialysis Potassium Prescribing.

This will be a randomized controlled pilot trial comparing usual care to a precision approach to dialysis potassium prescribing. The precision approach will incorporate point of care testing of blood potassium concentration prior to each dialysis session and adjustment of the dialysate K prescription with a blood-dialysate K gradient minimization strategy (PKRxHD).

Inclusion Criteria:

• Undergoing in-center, 3x/weekly HD for treatment of end-stage kidney disease (ESKD) for at least 90 days
• Age at least 21 years
• Prescribed HD time up to 15 hours/ week

Exclusion Criteria:

• Incarcerated
• Life expectancy of 1 year or less
• Kidney transplant, transition to home dialysis, or transfer to non-participating HD unit anticipated within 6 months or less
• Cognitive condition that precludes consent
• Severe anemia (hemoglobin < 8.0 g/dL) within 30 days
• K concentration of 7.0 mEq/L or more within 60 days
• Pregnant women
• Women of childbearing potential actively trying to conceive unwilling to use contraception
• Participation in other interventional studies within 30 days prior to enrollment