Comparing Personalized Incremental Hemodialysis to Standard Treatment for Adults with Kidney Disease Needing Dialysis

What this Trial Is About

Researchers are evaluating the clinical effectiveness of incremental hemodialysis compared to conventional hemodialysis in adults with kidney dysfunction who require dialysis but still have some kidney function. The study aims to assess differences in survival, hospitalization, kidney function preservation, quality of life, fatigue, employment, and caregiver burden. This trial is designed to provide personalized dialysis care tailored to patient needs versus the standard thrice-weekly treatment. Participants will be randomized to receive either incremental hemodialysis, starting at twice weekly with individualized adjustments based on residual kidney function, or conventional hemodialysis administered three times a week. The incremental group will also receive additional medications to support body fluid and electrolyte balance. Caregivers of enrolled patients will be followed alongside patients for up to two years after randomization. During the study, patients and their caregivers will be monitored regularly with various assessments including quality of life questionnaires, cognitive tests, caregiver burden scores, urine output and kidney clearance measurements, and hospitalization tracking. Data will be collected at baseline and multiple intervals over two years. Researchers will track clinical safety events and examine how treatments affect daily functioning and recovery time after dialysis sessions.

Incremental Hemodialysis: The TwoPlus Trial