Dialysis (Canada) (priority setting in association with the JLA)

About this PSP

Andreas Laupacis MD, MSc, FRCPC, from St. Michael’s Hospital, Toronto, Canada, and colleagues used the JLA approach to priority setting in research, focusing on people who were on dialysis or shortly to start dialysis in Canada. They received 1,820 uncertainties from 317 survey respondents.

They assembled a steering committee of patients, caregivers, nephrologists, researchers and an individual from the Kidney Foundation of Canada, and were guided by the input of Sally Crowe from the JLA.

The study was supported by the Kidney Foundation of Canada and the Canadian Institutes of Health Research.

The Dialysis (Canada) Top 10 was published in May 2014.


Articles and publications

Top 10 uncertainties

  1. What is the best way to enhance communication between health-care professionals and patients and to maximize patient participation in decision-making with regards to the advantages and disadvantages of different forms of dialysis, and access to test results to facilitate self-management?
  2. How do different dialysis modalities compare in terms of their impact on quality of life, mortality and patient acceptability, and are there specific patient factors that make one modality better for some patients with kidney failure than others?
  3. What are the causes and effective treatment(s) of, and ways to prevent, itching in dialysis patients?
  4. What is the best strategy to increase kidney transplantation; including access to transplantation, increasing the efficiency of the recipient workup, and increasing the availability of donor kidneys?
  5. What is the psychological and social impact of kidney failure on patients, their family, and other caregivers, and can this be reduced?
  6. What are the best ways to promote heart health in dialysis patients, including management of blood pressure?
  7. For people with kidney failure, what is the impact of each of the dietary restrictions (sodium, potassium, phosphate) separately, and when taken in combination, on important outcomes including quality of life?
  8. What are the best ways to manage symptoms in people on or nearing dialysis including poor energy, nausea, cramping, and restless legs?
  9. What are the causes and effective treatment(s) of depression in dialysis patients?
  10. What is the best vascular access (among both new and existing types of access) for people on hemodialysis?