Bioimpedance spectroscopy to maintain renal output: The BISTRO trial

The purpose of the trial is to test whether taking regular measurements with a bioimpedance device, which gives information about body composition, improves outcomes for people who have recently started haemodialysis treatment for their kidney failure.

One of the main functions of dialysis is to control the amount of fluid in the body; too much or too little fluid can lead to harm. Bioimpedance (BI) is a simple, bedside measurement giving information about body composition, in particular how much excess fluid is present. Clinicians can use this to guide how much fluid should be removed by dialysis in conjunction with the normal clinical assessment of the amount of fluid in the body, but it is not known if this results in better decisions and outcomes for patients.

BISTRO recruited 439 participants to a multi-centre randomised control trial (RCT) from over 30 dialysis units nationwide. The trial tested whether taking regular measurements with a bioimpedance device improves outcomes for people who have recently started haemodialysis treatment. The team's main aims were to see if this helps maintain their remaining kidney function as this is associated with improved survival, fewer symptoms of kidney failure, fewer side effects of the dialysis treatment and a better quality of life and if sharing the bioimpedance information with patients would lead to greater involvement and participation in their treatment.