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BACKGROUND Intradialytic hypotension is the most common complication of haemodialysis (HD) treatments. Excessive ultrafiltration results in reduced cardiac preload. We aimed to determine whether a fall in systolic blood pressure during HD was greater in patients starting HD with (1) less overhydration measured by extracellular water (ECW) and (2) lower cardiac pre-load by cardiac magnetic resonance imaging (MRI). METHODS Pre-HD measurements of ECW and total body water (TBW) were performed using multi-frequency bioimpedance (MFBIA). Cardi