Click above to watch a video of Sister Jacqui Caskey, haemodialysis unit sister, discussing dialysis treatment for kidney failure.

Click above to watch a video of Dr Emma Murphy discussing non-dialysis treatment for kidney failure.

There are two pathways that patients will follow as part of the Prepare for Kidney Care study – preparation for dialysis and preparation for responsive management. Versions of both of these approaches are used by patients undergoing standard NHS care. Responsive management is based on currently available NHS treatments, sometimes called ‘conservative’ or ‘supportive’ care.

​Preparation for renal dialysis 

Patients on this pathway will prepare for renal dialysis in the same way as other people undergoing NHS care. The treatment aim is to maximise quality and quantity of life, using artificial kidney replacement if kidney failure develops. Preparation for renal dialysis includes regular contact with the kidney team, usually at hospital visits.

​Patients will prepare for either haemodialysis or peritoneal dialysis depending on their preferences, guided by their kidney team. Preparation may include surgery to create dialysis access, for example a fistula (external link). The renal dialysis pathway is based on practice that currently happens wherever the patient lives.

​We estimate that one in three people eligible for the trial will develop kidney failure. These people will start renal dialysis if they and their kidney teams agree that this is the right thing to do. Regular contact, usually in the dialysis unit, will be available so problems can be discussed and dealt with.

​Preparation for responsive management

Patients on this pathway will prepare for responsive management in the same way as other people undergoing NHS care. The treatment aim is to maximise quality and quantity of life, without the use of artificial kidney replacement if kidney failure develops. Patients will not prepare to start renal dialysis. Preparation for responsive management includes regular contact with the kidney team, with a mixture of hospital and home visits. 

Patients will prepare for responsive management by working with their kidney team and GP to deal with social, psychological and physical needs. They will make plans about how they want to be looked after if their general or kidney health gets worse. The responsive management pathway has been specifically designed for this study, based on examples of practice that currently happen around the country.

We estimate that one in three people eligible for the trial will develop kidney failure. These people will start responsive management – carrying out the plans that they made, if they and their kidney teams agree that this is the right thing to do. Regular home visits and telephone calls will be conducted so problems can be discussed and dealt with.