An Extension to Assess the Effect of Expanded Dialysis on Patient Reported Symptoms Using LEVIL

Determine if the clearance of larger middle molecular weight toxins using medium-cut-off dialyzer (HDx -Theranova) effects patient reported symptoms as determined by LEVIL.

Investigators know that many patients who are on dialysis suffer from burden of unwanted
 symptoms, which can affect quality of life. The understanding and treatment of symptom burden
 by healthcare providers is limited and should be recognized as a high priority in the care of
 the dialysis population. In this study, the investigators will be assessing symptom burden
 using the London Evaluation of Illness LEVIL, an application based platform where patients
 self-report their symptoms with one to three hemodialysis treatments per week for 28 weeks.
 The investigators would like to compare the currently available dialyzer with a new dialyzer
 that is capable of removing solutes of higher molecular weight that may or may not cause
 patients to experience symptoms related to increased amounts of toxins in their blood.