Preparing for responsive management versus renal dialysis in older people living with kidney failure and frailty or multimorbidity in the UK (Prepare for Kidney Care): a two-arm, superiority, parallel-group, open-label, pragmatic, phase 3, individually randomised controlled trial.

Lancet (London, England)·November 4, 2026·PMID 42982076

Why it matters

Older patients with kidney failure and frailty or multimorbidity often face uncertain benefit from dialysis, yet comparative effectiveness data are scarce. This trial provides direct evidence that a conservative approach yields similar quality-adjusted survival to dialysis, supporting shared decision-making that prioritizes patient goals and reduces invasive procedures.