Incremental Hemodialysis: The TwoPlus Trial

Prior treatment

• not have experienced severe life events within prior 3 months of enrollment (through direct inquiry from the person)

Other illness

• have no known psychiatric and neurologic disorders (through direct inquiry from the person)
• not be the caregiver for another patient with chronic illness

Lab values

• Pre-HD serum K ≥5.8 mEq/L, Na ≤125 mEq/L, or bicarbonate level ≤17 mEq/L

Age

• be at least 18 years old

Other

• Requirement or anticipated requirement of high-volume ultrafiltration
• Unable or unwilling to follow the study protocol for any reason
• Known pregnancy or planning to attempt to become pregnant or lactating women
• Estimated survival or dialysis modality change or center transfer \<6 months
  • Caregiver Eligibility Criteria:
• be the main caregiver (at patient's choice)
• be a close relative of the patient (spouse, child, sibling, parent, grandchild)
• not be a member of the medical or healthcare team

• Clinical Inclusion Criteria:
• Age ≥ 18 years
• Incident kidney dysfunction requiring dialysis (KDRD) started on maintenance, in-center hemodialysis (HD), or anticipated to be started on maintenance, in-center HD within the next 12 weeks
• Has received ≤36 sessions of intermittent HD (i.e., on HD for ≤12 weeks) at the time patient is approached for potential study participation
  • Residual Kidney Function Inclusion Criteria:
• Kidney urea clearance ≥ 2.0 mL/min
• Urine volume# of ≥500 mL/24 h

Criteria the registry did not label

• Patient eligibility Criteria: