Study Comparing Starting Haemodialysis Twice Weekly Versus Thrice Weekly to Improve Quality of Life in Adults with Kidney Failure

What this Trial Is About

Kidney failure is a serious health problem that requires treatment with dialysis or transplantation to survive. Haemodialysis, the most common treatment, can cause symptoms like fatigue, pain, cramps, and poor quality of life, with less than 60% of full health reported by patients. Early mortality rates are high, especially in the first 3 to 6 months after starting haemodialysis at the usual three sessions per week. This trial investigates whether starting haemodialysis incrementally at two sessions per week preserves quality of life and kidney function better than conventional treatment. The study compares two approaches incremental haemodialysis, where participants begin with two sessions per week and increase to three sessions only if needed, and conventional haemodialysis, where participants start with three sessions per week from the beginning. This randomized, open-label trial will recruit 372 participants across centers in Australia and Canada. The goal is to assess if the incremental method is a safe, practical, and cost-effective alternative that reduces the physical and financial burdens of dialysis. Participants will be followed for up to 18 months, with quality of life assessed at 6 months using the Kidney Disease Quality of Life Short Form questionnaire as the primary measure. Additional assessments include kidney function, healthcare use and costs, mortality, hospital admissions, symptoms, fatigue, nutritional status, and vascular access, collected at regular intervals. The study will monitor safety and side effects throughout the trial period to provide comprehensive data on the impacts of both dialysis approaches.

INCremental Dialysis to Improve Health Outcomes in People Starting Haemodialysis (INCH-HD)