TwoPlus

Projects & Initiatives

In the Two Plus Study, the researchers are comparing incremental hemodialysis with conventional hemodialysis.

Incremental Hemodialysis

This begins with two hemodialysis treatments per week plus medications (fluid pills, bicarbonate acid buffer, potassium binder). When the kidney function gets low, or if medical condition declines, dialysis is increased to three hemodialysis treatments per week. More frequent dialysis (e.g., four hemodialysis treatments per week) can also be prescribed.

Conventional Hemodialysis

This begins with three hemodialysis treatments per week More frequent dialysis (e.g., four hemodialysis treatments per week) can also be prescribed.

Who can participate?

Your doctor will make the decision based on the following key characteristics:

  • You are 18 years or older.
  • You have advanced kidney disease that requires chronic dialysis and elected to proceed with incenter hemodialysis.
  • You had no more than 18 hemodialysis sessions.
  • Your kidneys can still clear a certain amount of urea waste.
  • You are producing at least 500 mL of urine in 24 hours.

Expected benefits and goals

With the help of patients, doctors, nurses, dietitians, and social workers, the study will be conducted at many dialysis units in the United States. We’ll gather feedback from patients, caregivers, and healthcare providers from all participating units to ensure that the study fits smoothly into regular clinical care.

Our goal is to find a safe and effective hemodialysis treatment plan that improves quality or life and helps facilitate informed choices about dialysis treatment options.

What is Expected During the Study?

  • Every 3 months, you will need to collect all the urine you produce from one day to another.
  • Hemodialysis prescription will change according to your medical needs.
  • You will be asked to answer questionnaires.

Compensation

You will receive an honorarium for taking part in the study-related activities and completing urine collections.

More information

Resources for Researchers