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Chronic subclinical volume overload happens very frequently in hemodialysis patients and is associated directly with hypertension, increased arterial stiffness, left ventricular hypertrophy, and ultimately higher mortality.

Randomized controlled parallel-group trial.

131 patients from one hemodialysis center, randomly assigned into 2 groups.

Dry weight prescription using results derived from repeated 3-month bioimpedance measurements to guide ultrafiltration for strict volume control (bioimpedance group; n = 62) compared with clinical judgment without bioimpedance measures (clinical-methods group; n = 69) for 2.5 years.

The primary outcome was all-cause mortality over 2.5 years (the duration of the intervention). Secondary outcomes were change in relative arterial stiffness, fluid overload, and blood pressure (BP) over 2.5 years.