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BACKGROUND AND OBJECTIVE: Non-adherence to fluid intake restrictions is one of the leading problems in hemodialysis patients. The consequences of chronic volume overload and massive hypotensive episodes resulting from enhanced ultrafiltration lead to an increased mortality and incidence of vascular events. Telemetric body weight monitoring (TBWM) suggests itself as a successful way to reduce daily fluid intake PATIENTS AND METHODS: This monocentric, prospective, randomized open study includes 120 patients with end-stage renal failure undergoing chronic hemodialysis (for at least two months) three times a week. The mean interdialytic weight gain (IWG) was more than 1.5 kg/2 days over the four weeks immediately before start of the study. The effect of daily body weight telemonitoring on IWG, blood pressure, haemoglobin variability, hospital stay, vascular events and mortality were observed for three months. All monitored patients (group 1, n = 60) received a weekly report of their weight changes, the number of alarms (automatically sent by email to the study center when daily IWG was greater than 0.75 kg/d) and of the interventions by phone (conducted by the responsible nephrologist when IWG was > 2 kg/day). Hemodynamics (each hemodialysis procedure) and weekly laboratory data were recorded for all patients. RESULTS: Preliminary data of 44 patients showed a significant reduction of daily IWG (weekly average, p = 0.0187) and a smaller number of alarm reports after the whole study period in group 1. Blood pressure monitoring during hemodialysis showed less hyper- and hypotensive episodes in patients with an IWG of less than 1.5 kg/2 days. In the control group there have so far been no changes of the analysed parameters. CONCLUSIONS: TBWM seems to be an effective method for optimizing adherence to fluid intake restrictions in patients on hemodialysis. Hemoglobin variability, mortality rates and the number of vascular events will still have to be analysed in detail for all patients once the entire study period has been completed.