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Preoperative Hemodialysis Timing in Patients With End-Stage Kidney Disease: The POD-ESKD Pilot Trial

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

1. Patient is willing to comply with all study procedures for the duration of the study
2. Patient has a diagnosis of ESKD
3. Patient initiated hemodialysis at least 90 days prior to the planned surgical procedure
4. Patient is treated with a stable hemodialysis schedule, defined as an average of 2.5- 3.5 hemodialysis sessions per week in the preceding 4 weeks prior to surgery
5. Patient is scheduled to undergo nonemergent surgical procedures in the Stanford Health Care system. This includes (but is not limited to):

   * Fistula or graft creation, revision, or removal
   * Fistulogram
   * Peritoneal dialysis catheter placement or revision
   * Lower extremity angiogram (including femoral and iliac vessels)
   * Lower extremity bypass (including femoral and iliac vessels)
   * Lower extremity amputation
   * Lower extremity endarterectomy (including femoral and iliac vessels) Of note, this list of procedures is not exhaustive and other procedures may be considered that meet inclusion criteria and no exclusion criteria, in consultation with the treatment teams involved.

Exclusion Criteria:

1. Patient is pregnant
2. Patient is a prisoner
3. Patient is \< 18 years old
4. The treating clinicians determine that the patient's clinical condition necessitate a specific approach to surgical scheduling or preoperative hemodialysis

About the study

The goal of this clinical trial is to evaluate the feasibility of two different preoperative hemodialysis schedules for people with end-stage kidney disease (ESKD) who undergo surgical procedures. The main questions it aims to answer are:

Is it feasible to randomize participants with ESKD undergoing nonemergent surgical procedures to same-day hemodialysis versus no same-day hemodialysis?

Is it safe to randomize participants with ESKD undergoing nonemergent surgical procedures to same-day hemodialysis versus no same-day hemodialysis?

Researchers will compare the two hemodialysis schedules to see if the scheduling and safety profiles are the same.

Participants will:

Answer questions about their health up to 4 weeks before and 4 weeks after the surgical procedure.

Receive hemodialysis on the day of the surgical procedure or not, depending on the study treatment assignment.

What is being tested

• Same-Day Hemodialysis (procedure)
• No Same-Day Hemodialysis (procedure)

Sponsor: Stanford University · Participants: 30 · Started: May 27, 2026

Contact the study team

Official record on ClinicalTrials.gov — NCT07339202

Locations in the U.S.

Conditions

• Kidney Failure

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.