Dialysis Less Frequently in the Elderly

NCT07738731 — Not applicable, Not yet recruiting, 210 participants, Queen's University

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  

A Randomized Controlled Study of Dialysis Less Frequently in the Elderly

RegistryNCT07738731, acronym DLITE
StatusNot yet recruiting
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment210 (Estimated)
SponsorQueen's University (Other)
ConditionsHemodialysis, End Stage Kidney Disease (ESKD)
InterventionsTwice weekly hemodialysis, Thrice weekly hemodialysis treatment (Other)
Datesstart 2026-10-01 (estimated), primary completion 2031-10-01 (estimated), completion 2031-10-01 (estimated), first posted 2026-07-31, last updated 2026-07-31
Locations11 sites in Canada

Related Papers Related Patents Related Grants Related Experts
All trials for Hemodialysis All trials for End Stage Kidney Disease (ESKD) All trials of Twice weekly hemodialysis All trials of Thrice weekly hemodialysis treatment

-Summary

Many people who have kidney failure require hemodialysis treatments to stay alive. Hemodialysis is a procedure that cleans the blood of the toxins and fluids that build up when kidneys don't work. Most patients receive hemodialysis treatment three times every week and each treatment lasts 4 hours. These patients spend 156 days per year receiving hemodialysis treatments. This is a very large time burden which has a tremendous impact on well-being and life satisfaction. Current usual approach of prescribing three hemodialysis treatments per week is not based on good studies and assumes that all people need the same number of hemodialysis treatments per week regardless of their age, values, life expectancy or other health conditions. Over time, increasingly more elderly people are needing to start hemodialysis treatments. The investigators have conducted a preliminary study that shows that patients who are 70 years of age or older can do well when only receiving only two hemodialysis treatments per week. In this preliminary study, receiving two hemodialysis treatments per week was no different than three hemodialysis treatments per week with regards to important safety measures including blood values and management of body fluid levels. The investigators now propose to carry out a much larger study in many centers across Canada that will compare two times per week hemodialysis treatments to three times per week hemodialysis treatments in elderly patients who have reached kidney failure and are beginning their hemodialysis journey. The investigators want to know if receiving hemodialysis treatments twice per week increases the number of days that a patient is able to spend at home without increasing rates of hospitalization or death compared to receiving hemodialysis treatments three times per week. The investigators also want to know if this is better for people's quality of life, safe, less expensive for the health care system and friendlier to the environment. The results of this study will help elderly patients needing to start hemodialysis treatments, medical care teams who help make decisions about how many hemodialysis treatments per week are necessary as well as kidney organizations that oversee kidney care for patients in Canada and around the world.

Expand all sections  ·  Collapse all

+Arms and interventions

ArmTypeInterventionsDescription
Twice weekly hemodialysis treatmentExperimentalOther: Twice weekly hemodialysisThis arm will receive two hemodialysis treatments per week
Thrice weekly hemodialysis treatmentActive comparatorOther: Thrice weekly hemodialysis treatmentThis arm will receive three dialysis treatments per week
  • Twice weekly hemodialysis (Other), also known as Twice weekly hemodialysis treatment: Twice weekly hemodialysis
  • Thrice weekly hemodialysis treatment (Other): This arm will receive three hemodialysis treatments per week

+Outcome measures

Primary outcomes

  • Days Alive and Out of Hospital [365 days]: Days Alive and Out of Hospital is an important patient-centered goal and outcome that approximates time spent at home.

Secondary outcomes

  • Days Alive and Out of Hospital [2 years]: Days Alive and Out of Hospital is an important patient-centered goal and outcome that approximates time spent at home
  • Quality-adjusted life years [2 years]: Impact of treatment frequency on Quality-adjusted life years
  • Change in Edmonton Symptom Assessment Scale-revised Renal score from baseline to average of all follow-up assessments [2 years]: Impact of treatment frequency on Quality of Life measures as assessed by the Edmonton Symptom Assessment Scale-revised Renal instrument (range 0-120 with higher scores mean a worse quality of life)
  • Change in Kidney Dialysis and Quality of Life-36 scores from baseline to average of all follow-up assessments [2 years]: Impact of treatment frequency on quality of life as assessed by the Kidney Dialysis and Quality of Life-36 instrument (Each subscale score ranges from 0-100 where higher scores mean a better quality of life)
  • Clinical Frailty Scale score [2 years]: Average of all follow-up Clinical Frailty Scale score assessments controlling for baseline (range 1-9 with higher scores meaning higher frailty)
  • Number of urgent unscheduled hemodialysis treatment for hyperkalemia [2 years]: Impact of intervention on potassium control
  • Number of urgent unscheduled hemodialysis treatment for volume overload [2 years]: Impact of treatment frequency on volume overload
  • Weekly pre-hemodialysis potassium levels > 5.9 mmol/L [2 years]: Impact of treatment frequency on potassium control
  • Change in urine volume [2 years]: Impact of treatment frequency on volume of urine output
  • Hospitalization [2 years]: Impact of treatment frequency on the number and days of hospitalization
  • Kidney function recovery [2 years]: Impact of treatment frequency on the number of participants recovering kidney function
  • Elective withdrawal from hemodialysis treatment [2 years]: Impact of treatment frequency on the number of participants who choose to withdraw electively from hemodialysis treatment
  • Cost [2 years]: Impact of treatment frequency on health care cost attributed to hemodialysis treatment
  • Environmental costs attributed to hemodialysis treatment [2 years]: Impact of treatment frequency on the environmental cost attributed to hemodialysis treatment
  • mortality [2 years]: impact of treatment frequency on mortality

+Eligibility

Sex: All, ages: 70 Years to any

Inclusion Criteria:

1. patients aged 70 or above
2. have developed end stage kidney disease and require hemodialysis treatment

Exclusion Criteria:

1. Hospitalized patients without an alternate level of care designation
2. Those with missed hemodialysis sessions due to non-adherence during the first 7 weeks of hemodialysis treatment
3. Patients already prescribed twice weekly hemodialysis
4. Patients who are medically unsuitable as per primary care team and site investigator
5. anticipated significant barriers to ascertainment of patient-reported experience measures

+Locations (11)

FacilityCityCountryStatus
Multiple SitesVancouver, British ColumbiaCanada
Memorial UniversitySt. John's, Newfoundland and LabradorCanada
Dalhousie UniversityHalifax, Nova ScotiaCanada
Queen's UniversityKingston, OntarioCanada
CHUMMontreal, QuebecCanada
Hopital du Sacre-Coeur-de-MontrealMontreal, QuebecCanada
Hopital du Sacre-Coeur-de-MontrealMontreal, QuebecCanada
Hopital Maisoneuve-RosemontMontreal, QuebecCanada
Hôpital du Haut-RichelieuMontreal, QuebecCanada
McGill UniversityMontreal, QuebecCanada
Centre de Recherche du CHU de Quebec: Laval UniversityQuébec, QuebecCanada

+Publications

  • Moorman D, Pilkey NG, Goss CJ, Holden RM, Welihinda H, Kennedy C, Halliday SM, White CA. Twice versus thrice weekly hemodialysis: A systematic review. Hemodial Int. 2022 Oct;26(4):461-479. doi: 10.1111/hdi.13045. Epub 2022 Sep 12. PMID 36097718
  • White CA, Day AG, Holden RM. Response to the Letter to the Editor Entitled "Twice- Versus Thrice-Weekly Hemodialysis in the Elderly: Are we 'DLITE'd? Kidney Int Rep. 2026 Jan 19;11(4):103782. doi: 10.1016/j.ekir.2026.103782. eCollection 2026 Apr. No abstract available. PMID 41717127
  • White CA, Welihinda H, Day AG, Heyland DK, Holden RM. Pilot Randomized Trial of Dialysis Less Frequently in the Elderly: The DLITE Study. Kidney Int Rep. 2025 Sep 3;10(11):3796-3809. doi: 10.1016/j.ekir.2025.08.043. eCollection 2025 Nov. PMID 41278339