Dialysis Decisions (DD) V 1

  • Research type

    Research Study

  • Full title

    Dialysis Decisions: A preliminary qualitative study on patient decisions when considering options for renal replacement therapy.

  • IRAS ID

    236943

  • Contact name

    Ashar Wadoodi

  • Contact email

    Ashar.Wadoodi@stgeorges.nhs.uk

  • Sponsor organisation

    St Georges University Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 6 months, 22 days

  • Research summary

    Patients diagnosed with end stage renal failure may require dialysis which is the process of cleaning the blood of toxins and returning cleaned blood as a substitute for the normal function of the kidneys. The dialysis options available to patients are haemodialysis (HD) or peritoneal dialysis (PD). PD is achieved via the insertion of an external catheter into the abdominal cavity. There are several different ways to access HD; via a line, fistula or graft. HD via a line is achieved through an artificial tube placed in a large vein above the heart or in the neck. A fistula is the surgical creation of a circuit, using the patient’s own blood vessels and a graft is a fistula made out of artificial material.

    Patients are encouraged to participate in the decision-making regarding their treatment with the help of medical professionals. Medical studies have shown that a native fistula is the optimum choice for long-term effective access to dialysis, followed closely by the graft. They have better outcomes such as lower infection risk, better quality of dialysis and longer length of treatment sustainability. The Renal Association recommends that 65% of the incidence population start dialysis via a fistula or a graft and 85% of the prevalent population should dialyse via a fistula/graft. Despite this, the UK has a higher rate of catheter usage than other countries which goes against current medical advice. There is little research that specifically investigates patients understanding of treatment options and how these decisions are made.

    This study aims to explore the dialysis patient’s treatment decision making process through a structured interview of 10 – 20 dialysis patients. The aim is to explore how they navigated their treatment and identify any common facilitators or barriers that inform their treatment decisions which may provide insight into current preferences.

  • REC name

    East of England - Cambridge South Research Ethics Committee

  • REC reference

    18/EE/0087

  • Date of REC Opinion

    19 Apr 2018

  • REC opinion

    Further Information Favourable Opinion