Effect of Modifying Magnesium Concentration in Citrate-enriched Dialysate on Serum Magnesium Levels

To determine if a citrate enriched, Mg 1.0 mmol/L dialysate, when compared to a Mg 0,75 mmol/L citrate enriched dialysate leads to a:

• higher average serum predialysis total Mg on day 15 of the intervention
• higher average serum predialysis ionized Mg on day 15 of the intervention
• higher average serum postdialysis ionized Mg on day 15 of the intervention
• smaller proportion of patients with serum predialysis Mg <1,05 mmol/L on day 15 of the intervention
• larger proportion of patients with serum predialysis Mg > 1,50 mmol/L on day 15 of the intervention
• larger difference in predialysis Mg on day 15 versus day one of the intervention.

Inclusion criteria

• Written informed consent must be obtained prior to any screening procedures
• Clinically stable during two months prior to the study. This will be based upon clinical judgement.
• On stable blood pressure medication 4 weeks prior to the study
• Dialysis with a K3 dialysate
• Adequate double-needle dialysis access (fistula or catheter)
• Able to fill questionnaire/symptom score

Exclusion criteria

• Predialysis calcium <1,9mmol/L during baseline
• Magnesium predialysis >1,45mmol/L during baseline
• Patient has a history of child C liver cirrhosis
• Coronary intervention <3 months before randomization
• Hospitalization <2 months before randomization
• Uncontrolled predialysis hypertension >160/90mmHg despite 4 antihypertensive drugs
• Predialysis blood pressure <90mmHg during baseline visit
• History of dialysis access related problems <1 month before the randomization
• Chronic Atrial fibrillation
• NYHA class 4 heart failure
• Any disorder, which in the investigator's opinion might jeopardise participant's safety or compliance with the CIP.