Incremental haemodialysis offers selected patients a more gradual start to treatment by taking account of their remaining kidney function. Starting with fewer or shorter sessions can mean less time spent receiving dialysis, with treatment increasing as remaining kidney function declines. This personalised approach has the potential to reduce treatment burden and give people more time for their everyday lives. However, questions remain about how it is used in practice, which patients benefit and how outcomes compare with conventional haemodialysis.
The UKKA’s 2019 haemodialysis guideline recognises a role for incremental schedules in people with significant remaining kidney function. Careful patient selection and regular monitoring are essential to ensure that treatment continues to meet their needs.
Using data to understand UK practice
A planned analysis using UK Renal Registry (UKRR) data will examine which patients start on incremental treatment, how its use varies between centres and how long patients remain on a reduced schedule before moving to a conventional prescription.
This will help establish a clearer picture of UK practice and could identify differences in access to incremental treatment. The wider research questions include whether incremental haemodialysis helps preserve remaining kidney function and how it affects patient outcomes, quality of life and treatment burden.
Contribute your experience
To inform this work, Dr Maria Pippias, Deputy Director of Informatics Research at the UKRR, and Dr Rachel David, Consultant Nephrologist in Bristol, have launched a national survey exploring current practice and barriers to offering incremental haemodialysis.
Nephrologists, nephrology trainees, dialysis specialist nurses and other healthcare professionals involved in haemodialysis care are invited to participate.
The survey focuses on people starting haemodialysis on less than the conventional schedule of four hours, three times a week, with the intention of increasing treatment as remaining kidney function declines. It does not cover reducing treatment for people already established on haemodialysis.
It takes 5–10 minutes to complete and closes on 13 November 2026.
Complete the incremental haemodialysis survey
For questions, contact Dr Rachel David.
