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Dialysis should not necessarily be regarded as the default option for older people with kidney failure, the first randomized study of its kind in the world, led by the University of Bristol, has found.

The research, published in The Lancet, suggests a structured, less medicalized approach without dialysis may offer an alternative without compromising a person's overall length and quality of life.

The findings of the major study are from the "Prepare for Kidney Care" trial. The trial investigated whether older people living with kidney failure and multiple health conditions or frailty would benefit more from dialysis or from a structured program of care that does not include dialysis, looking at both quality of life and survival.

The aim of the study was to provide far better evidence to help patients and their families reach the best decision for them and influence NHS policy on care for this group of patients.

The trial, led by the University of Bristol in collaboration with the Bristol NHS Foundation Trust, recruited 445 participants from 31 U.K. kidney centers, representing around half of all U.K. kidney services.

Around 75% of participants were aged 80 or over, with the remaining 25% aged 65–79 and having additional health problems.

Participants were randomly allocated to one of two approaches: prepare for renal dialysis or prepare for responsive management (a form of conservative kidney management ), and were followed over time.

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