The site inclusion criteria are:

• Predominantly dialyses adults (≥18 years old) receiving maintenance haemodialysis
• Rates of withdrawal within the first two years of commencing dialysis for social reasons have been less than 15% for the 2 years prior to recruitment and are not expected to increase above 15%
• Has a minimum of 10 dialysis recipients at time of randomisation
• Utilises a default dialysate sodium concentration at the time of recruitment (a substantial majority of dialysis sessions are conducted with the default dialysate sodium concentration)
• Is a self-contained unit (i.e. unit patients do not regularly rotate through another unit. Brief trips by patients to a parent or other unit do not exclude a site)
• Willing to accept randomisation to either intervention (as determined by nominated Director of Unit)
• Is not a home dialysis training or support unit. [Sites that include both in-center/satellite dialysis patients and home patients may participate but the study procedures and assessments will only be conducted in the incenter/satellite component of the site].

The exclusion criteria are:

• Not able to comply with data collection methods