Feasibility of a Randomized Cluster Trial for Blood Pressure Targets in In-centre Hemodialysis Units

"To increase systolic blood pressure, treating physicians can consider the following options:~1. Withdraw blood pressure medications, reducing dose of medications that are not indicated for other reasons, or down titrate medication.~2. Increase estimated dry weight (EDW) by 0.5 kg increments if the participant is hypovolemic or euvolemic"

"To decrease SBP, treating physicians can consider the following options:~1. Adjust blood pressure medications. This could be accomplished by increasing the dose of current medications, and/or adding an additional medication class. Choice of medication will be dependent on current medications, contraindications, age, comorbidities, and cardiovascular indications. Adherence to blood pressure medications should be reviewed.~2. Reduce EDW by 0.1 - 0.5 kg~3. Reduce sodium levels. This could be accomplished through a reduction in dietary sodium intake to \<2 gm/day and fluid intake to \<1.5 L per day. Adherence to dietary sodium restrictions should be reviewed with the participant~4. Extend dialysis time or adding an additional dialysis session if needed to achieve target dry weight"