Supported Research

General Audience Summary

Prospective Changes in Quality of Life and Frailty in Chronic Kidney Disease Patients Transitioning to Home versus in-Center Dialysis (QUALIFY CKD-to-HOME)

Background: For people with advanced kidney disease who choose to have dialysis, deciding which type of dialysis is best can be challenging. Many kidney programs will recommend home dialysis (peritoneal dialysis and home hemodialysis) because we think these techniques have advantages compared to hemodialysis performed in hospitals. These advantages include more autonomy, facility to travel, flexible schedule and, in some cases, lower risk of being hospitalized or dying. Studies have shown that quality of life, having the ability of participate in life and not having too much fatigue are very important to patients. It is thought that the quality of life of people receiving their dialysis at home is often better than the one of people receiving dialysis in a hospital. However, we do not know how the start of dialysis changes the quality of life of people who choose home dialysis in comparison to people choosing hemodialysis in a hospital. We also believe that people who receive dialysis at home often have a better health, mobility, and function level than people with dialysis in hospital who are often frailer. Currently, it is uncertain if people receiving home dialysis can maintain their functioning level after start of dialysis. We also do not know if frail people starting dialysis at home will have a better functioning level after 1 year than those starting dialysis in hospital.

Method: We will perform a prospective study following adult with advanced kidney disease who progress to dialysis and receive home or hospital-based dialysis. In this study, we aim to examine the change in patients’ quality of life and their frailty status (health, mobility and function) before start of dialysis up to 12 months after dialysis start. We are especially interested in comparing the differences between people doing home dialysis and hospital-based dialysis. We will use questionnaires to measure quality of life and several tools to evaluate frailty.

Conclusion: We hope that the results of this study will improve the care of people starting dialysis, both at home and in hospital. This study will inform kidney teams on periods where patients may need more support after start of dialysis, especially when treated at home, and help to design interventions to improve patient’s experience on dialysis.