The BISTRO Trial

BioImpedance Spectroscopy To Maintain Renal Output


BISTRO is an NIHR HTA funded pragmatic, multicentre randomised controlled trial to determine if incorporation of bioimpedance into the setting of the post dialytic weight reduces loss of residual kidney function in incident centre-based HD patients, with the potential to improve clinical outcomes, in particular dialysis related symptoms, hospitalisation and survival.


Cheif Investigator: Professor Simon Davies
Associate Investigator:  
Trial Manager: Dr Nancy Fernandes da Silva
Sponsor / Reference Number: Keele University / RG_0012_16_IACS
Funder / Reference Number: NIHR Health Technology Assessment (HTA) Programme / 14/216/01
UKCRN Study Portfolio Reference Number: 31766
Registration Reference Number: ISRCTN11342007
Start Date: 01 Jun 2016
End Date:  31 Jan 2022

This is a Pragmatic, Multicentre, Open-Label Prospective Randomised Controlled Trial.

Primary objective: 

To recruit 516 patients commencing HD to the trial, sufficient to demonstrate a clinically significant difference in time to anuria in those randomised to the Bioimpedance Spectroscopy (BI) intervention limb versus those randomised to the control limb.

Secondary objectives:

To determine effect of intervention on:

  • The rate of decline in kidney function
  • Significant events, including vascular access failure and associated interventions, cardiovascular events, hospital admissions and deaths
  • Dialysis efficacy and safety
  • Patient reported outcomes, including quality of life dialysis-related symptoms, Integrated Palliative Care Outcome Scale- Renal, Patient Activation, Physical function, cognitive function

Cost-effectiveness of the intervention.

BMC Nephrol. 2017; 18: 138.
Published online 2017 Apr 26. doi: 10.1186/s12882-017-0554-1