Worthington, JoSoundy, AlexandraFrost, JessicaRooshenas, LeilaMacNeill, Stephanie JRealpe Rojas, AlbaGarfield, KirstyLiu, YumengAlloway, KarenBen-Shlomo, YoavBurns, AineChilcot, JosephDarling, JosDavies, SimonFarrington, KenGibson, AndrewHusbands, SamanthaHuxtable, RichardMcNally, HelenMurphy, EmmaMurtagh, Fliss E MRayner, HughRice, Caoimhe TRoderick, PaulSalisbury, ChrisTaylor, JodiWinton, HelenDonovan, JennyCoast, JoannaLane, J AtheneCaskey, Fergus J2024-11-112024-11-112024-10-17Trials . 2024 Oct 17;25(1):688.1745-621510.1186/s13063-024-08509-839420412http://hdl.handle.net/20.500.14200/6470This is a two-arm, superiority, parallel group, non-blinded, individual-level, multi-centre, pragmatic trial, set in United Kingdom National Health Service (NHS) kidney units. Patients with advanced CKD (estimated glomerular filtration rate < 15 mL/min/1.73 m2, not due to acute kidney injury) who are (a) 80 years of age and over regardless of frailty or multimorbidity, or (b) 65-79 years of age if they are frail or multimorbid, are randomised 1:1 to 'prepare for responsive management', a protocolised form of conservative kidney management, or 'prepare for renal dialysis'. An integrated QuinteT Recruitment Intervention is included. The primary outcome is mean total number of quality-adjusted life years during an average follow-up of 3 years. The primary analysis is a modified intention-to-treat including all participants contributing at least one quality of life measurement. Secondary outcomes include survival, patient-reported outcomes, physical functioning, relative/carer reported outcomes and qualitative assessments of treatment arm acceptability. Cost-effectiveness is estimated from (i) NHS and personal social services and (ii) societal perspectives.en© 2024. The Author(s).Nephrology/Renal medicinePalliative careArticleTrials