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The Prepare for Kidney Care Study: prepare for renal dialysis versus responsive management in advanced chronic kidney disease

Murphy, Emma; Burns, Aine; Murtagh, Fliss E.M.; Rooshenas, Leila; Caskey, Fergus J


Emma Murphy

Aine Burns

Leila Rooshenas

Fergus J Caskey


Shared decision making in advanced chronic kidney disease (CKD) requires unbiased information on survival and person-centred outcomes known to matter to patients: quality of life, symptom burden and support from family and healthcare professionals. To date, when deciding between dialysis and conservative care, patients have had to rely on evidence from small observational studies. Clinicians recognize that like is not being compared with like in these studies, and interpret the results differently. Furthermore, support differs considerably between renal units. What patients choose therefore depends on which renal unit they attend. To address this, a programme of work has been underway in the UK. After reports on survival and symptoms from a small number of renal units, a national, mixed-methods study-the Conservative Kidney Management Assessment of Practice Patterns Study-mapped out conservative care practices and attitudes in the UK. This led to the Prepare for Kidney Care study, a randomized controlled trial comparing preparation for dialysis versus preparation for conservative care. Although powered to detect a positivist 0.345 difference in quality-adjusted life years between the two treatments, this trial also takes a realist approach with a range of person-centred secondary outcomes and embedded qualitative research. To understand generalizability, it is nested in an observational cohort study, which is nested in a CKD registry. Challenges to recruitment and retention have been rapidly identified and addressed using an established embedded mixed methods approach-the QuinteT recruitment intervention. This review considers the background to and progress with recruitment to the trial.


Murphy, E., Burns, A., Murtagh, F. E., Rooshenas, L., & Caskey, F. J. (2021). The Prepare for Kidney Care Study: prepare for renal dialysis versus responsive management in advanced chronic kidney disease. Nephrology Dialysis Transplantation, 36(6), 975-982.

Journal Article Type Article
Acceptance Date Jun 4, 2020
Online Publication Date Sep 17, 2020
Publication Date May 27, 2021
Deposit Date Sep 29, 2020
Publicly Available Date Sep 30, 2020
Journal Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Print ISSN 0931-0509
Electronic ISSN 1460-2385
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 36
Issue 6
Article Number gfaa209
Pages 975-982
Keywords Conservative care; Comparative effectiveness; Dialysis; Randomized controlled trial
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Copyright Statement
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

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