Dekker M, et al. - Researchers examined the interaction between pre-dialysis fluid status (FS) and pre-dialysis systolic blood pressure (pre-SBP) in relation to mortality in patients from the international Monitoring Dialysis Outcome Initiative (MONDO) database with a pre-dialysis multifrequency bioimpedance spectroscopy measurement in the year 2011. During a 90-day baseline period, all available parameters were used. One-year follow-up was carried out during which all-cause mortality was recorded. Cox models and a smoothing spline Cox analysis were used in order to evaluate links with outcome. The association between pre-SBP and outcome was found to be dependent on pre-dialysis FS. In patients with fluid overload (FO) or fluid depletion (FD), but not in normovolemic (NV) patients, disadvantages of low pre-SBP were apparent. An association of post-dialysis FD with improved survival was demonstrated. Interpreting pre-SBP levels in the context of FS and not as an isolated marker was recommended.