protocolSection identificationModule nctId: NCT06327750, orgStudyIdInfo id: NL83566.018.24, briefTitle: The Microcirculation, Dialysis Modality and Sequestered Salt, acronym: MIMOSA, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2024-06, primaryCompletionDateStruct date: 2027-12, completionDateStruct date: 2027-12, studyFirstPostDateStruct date: 2024-03-25, lastUpdatePostDateStruct date: 2024-03-25, sponsorCollaboratorsModule leadSponsor name: Amsterdam UMC, location VUmc, class: OTHER, collaborators name: Dutch Kidney Foundation, collaborators name: Niercentrum aan de Amstel, collaborators name: B.Braun Avitum AG, descriptionModule briefSummary: The aim of this clinical trial is to investigate the effect of 5 different dialysis treatments (combinations of dialysis mode and dialysis fluid sodium content) on the microcirculation (MC) and sequestered sodium content (SSC) in adult prevalent end-stage kidney disease (ESKD) patients treated with hemodialysis (HD) or hemodiafiltration (HDF). The main questions it aims to answer are:1. What are the effects on the sequestered sodium content and microcirculation after 4 weeks of treatment with the following dialysis modes?   * HDF with an expected zero diffusive sodium balance (Dialysate sodium concentration (DNa)= Plasma sodium concentration (PNa)) compared to   * HDF with an expected diffusive sodium efflux (DNa \< PNa, difference 3 mmol/L) compared to   * HD with an expected zero diffusive sodium balance (DNa = PNa) compared to   * HD with an expected diffusive sodium efflux (DNa \< PNa, difference 3 mmol/L) compared to   * Isolated ultrafiltration for 30 minutes followed by HD with an expected zero diffusive sodium balance (DNa = PNa)2. Are the SSC and MC interrelated in this patient group?This study is a randomized cross-over trial. Participants will be subjected to the abovementioned dialysis treatment modes in random order., conditionsModule conditions: End-stage Renal Disease, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: RANDOMIZED, interventionModel: CROSSOVER, interventionModelDescription: Randomized cross-over trial, primaryPurpose: TREATMENT, maskingInfo masking: NONE, enrollmentInfo count: 22, type: ESTIMATED, armsInterventionsModule interventions name: Hemodialysis (DNa = PNa), interventions name: Hemodialysis (DNa<PNa), interventions name: Hemodialysis after isolated ultrafiltration (DNa=PNa), interventions name: High volume hemodiafiltration (DNa=PNa), interventions name: High volume hemodiafiltration (DNa<PNa), outcomesModule primaryOutcomes measure: Skin microcirculation, primaryOutcomes measure: Sequestered salt content (SSC), secondaryOutcomes measure: Intradialytic hypotension, secondaryOutcomes measure: Change in intradialytic blood pressure, secondaryOutcomes measure: Peridialytic blood pressure, secondaryOutcomes measure: Change in CK-MB, secondaryOutcomes measure: Change in high sensitivity C-reactive protein (hs-CRP), secondaryOutcomes measure: Change in interleukin-6 receptor (IL-6R), secondaryOutcomes measure: Change in soluble CD163 (sCD163), secondaryOutcomes measure: Change in soluble intercellular adhesion molecule-1 (s-ICAM-1), secondaryOutcomes measure: Change in serum glycosaminoglycans, secondaryOutcomes measure: Change in syndecan-1, secondaryOutcomes measure: Change in vascular endothelial growth factor C (VEGF-C), secondaryOutcomes measure: Change in extracellular vesicles (EVs), secondaryOutcomes measure: Change in skin microcirculation, secondaryOutcomes measure: Change in sequestered salt content (SSC), secondaryOutcomes measure: modified Dialysis symptom index (mDSI), secondaryOutcomes measure: Thirst distress scale (TDS), secondaryOutcomes measure: EQ Visual analogue scale (EQ VAS), eligibilityModule sex: ALL, minimumAge: 18 Years, stdAges: ADULT, stdAges: OLDER_ADULT, contactsLocationsModule, hasResults: False