DWMAPPS – Dialysis Withdrawal Management Assessment of Practice Patterns Study

A national study in UK renal units on the practice patterns of dialysis withdrawal and palliative management for people with established kidney failure (Stage 5 chronic kidney disease, CKD5) on dialysis.

In patients with established kidney failure, the reported rate of deaths preceded by dialysis withdrawal is high. However, rates vary across studies and national renal registries. In addition, there are difficulties defining, classifying and tabulating dialysis withdrawal deaths. There is a need to understand the different patterns of palliative and end of life care for CKD5 patients on dialysis and how decisions to withdraw dialysis are made. This information will guide commissioners and providers of renal services in the development of palliative care for dialysis patients. It will also inform the future design of QUALYCARE Renal, a multicentre observational study to evaluate the quality of end of life care and dialysis withdrawal practice.

This survey questionnaire is based upon existing literature and input from our expert Group. It is based on the design and structure of CKMAPPS, a national study of practice patterns in UK renal units in the use of conservative kidney management (CKM).

This research study is being led by the University of Southampton, is funded by the National Institute of Health Research as a clinical lectureship award for Dr Murphy, and has the endorsement of the Renal Association.

This questionnaire will be sent via email to the Clinical Directors of all UK renal units. If the Clinical Director thinks a different member of staff in the renal unit should complete it they can delegate this task to the most appropriate person. Multiple respondents can also complete it as in CKMAPPS.

We would welcome returns by 31st August 2018. We are aiming to release the final report following data entry and analysis by early December 2018.

Dr Emma Murphy, NIHR Clinical Lecturer, University of Southampton, UK

Professor Paul Roderick, Professor of Public Health, University of Southampton, UK

Professor Fliss Murtagh, Professor of Palliative Care, University of Hull, UK

Professor Wim Van Biesen, Head of the Renal Division, Ghent University Hospital, UK

Professor Ken Farrington, Consultant Nephrologist, East & North Hertfordshire NHS Trust, UK

Professor Michael Germain, Nephrologist and Professor of Medicine Baystate Medical Center, Massachusetts, USA