Table 1 Inclusion and exclusion criteria for the REMOVAL-HD study

Inclusion criteria

 1. Established chronic in-centre haemodialysis (HD) patient (> 12 weeks on HD)

 2. Aged over 18 years

 3. Has a functioning Arteriovenous Fistula or Graft

 4. Either oliguric (< 500 mL/24 h based on 24 h urine collection within 12 weeks of screening) or anuric

 5. Able to give informed consent

Exclusion criteria

 1. Planned renal transplant within study intervention period

 2. Planned conversion to peritoneal dialysis or transfer to another dialysis unit within study intervention period

 3. Active chronic infection or significant active inflammatory conditions including autoimmune disease, inflammatory arthritis and active malignancy

 4. Life expectancy < 12 months

 5. Pregnancy or breast feeding

 6. Indication for haemodiafiltration (HDF) according to treating physician

 7. Dialysis catheter in situ

 8. Receiving immunosuppressant medication

 9. Current use of nutritional or dietary supplements to increase or reduce protein intake including protein powder or weight loss supplements and is unable to cease the supplement

 10. Serum albumin < 30 g/L (within 4 weeks of screening)

 11. Inability to complete study assessments