Evaluation of patient and staff acceptability of alternate day haemodialysis

Growing evidence exists that frequent haemodialysis regimes are associated with wide ranging clinical benefits to patients but at present these can only be provided in the home setting. Large numbers of patients dialyse thrice weekly in-centre with a long weekend break as they usually dialyse Monday/Wednesday/Friday or Tuesday/Thursday/Saturday. It has been shown in various registry studies that an increase in mortality and hospitalisation occurs after the long weekend break. If patients were to dialysis on alternate days, rather than thrice weekly they would potentially benefit from both receiving more frequent dialysis and from the removal of the long weekend break. Design of a future randomised trial to compare alternate day dialysis with thrice weekly dialysis will require significant organisational change. This proposed study is a preliminary step aimed to provide data that would guide the design of such a study by exploring patient and staff views on alternate day dialysis.
CLiCIR have been engaged to support collection and analysis of qualitative and quantitative data, aimed to inform a large scale trial in the future.