The Dialysis Outcomes and Practice Patterns Study

The DOPPS is a prospective cohort study of hemodialysis practices based on the collection of observational longitudinal data for a random sample of patients from dialysis facilities in a representative and random sample of units in twenty countries.

The samples of patients in each facility, and sample of facilities in each country, are designed to provide a reliable picture of practices and outcomes in each facility, and in each geographic area.

In view of differences in patient outcomes of mortality and morbidity by country and by dialysis unit, the study helps researchers:

  • Describe differences in practice patterns that correlate with differences in outcomes
  • Understanding the factors associated with patient outcomes will lead to improved patient care and lower mortality and morbidity

How has the DOPPS informed dialysis practice and policy?

Vascular Access

The DOPPS has shown that regional survival differences in mortality (particularly for the United States compared with Europe) were largely explained by differences in facility vascular access use. US and European facilities with similar percentages of fistula, graft, and catheter use have, on average, similar survival.

In recent years, with the Fistula First Initiative, there has been a commendable increase in fistula use in the United States, whereas in several other countries, fistula use has fallen and/or catheter use has risen substantially.

Dialysis Session Length

In recent years, DOPPS observes that dialysis session length has shortened in the United States, whereas it has gotten longer in most other DOPPS countries. By both standard and IV analyses, the DOPPS has found that longer treatment time is associated with lower mortality in models adjusted for Kt/V, ultrafiltration rate, and other characteristics.

According to the DOPPS, short dialysis session length is now one of the key practice differences between the United States and other DOPPS countries, and its implications merit attention from research and policy perspectives.

Quality of Life and the Patient Experience

In addition to quality of life being an important predictor of mortality, it is also an important end-point in itself. Recent research on the time it takes to recover from dialysis treatment shows  a great deal of variation among patients – some will recover in an hour or two but many others take all day to recover. For those patients, three days of every week are completely wiped out, in terms of any meaningful and enjoyable quality of life. This is a big issue for patients, and we plan to do more work to address this experience.

Investigators and Steering Committee

The DOPPS is overseen by the DOPPS Steering Committee and investigators representing each of the DOPPS countries, and coordinated by the Arbor Research Collaborative for Health (Arbor Research). Research is guided by these investigators, as well as Task Forces of experts in different study areas. 

To learn more about joining an investigator team or using DOPPS data, see Partner With Us.

Representing a panel of experts in nephrology in each of our DOPPS countries, Investigators provide country specific guidance for DOPPS researchers and data collectors. Country Investigators assist in facility recruitment, review and localize study questionnaires, and offer insight into ESRD issues pertaining to their respective countries.


Alex Disney, MD *

Peter Kerr, MD

Martin Gallagher, MD



Dr. Sumaya Al Ghareeb*

Dr. Ali Alaradi



Michel Jadoul, MD

Norbert H. Lameire, MD *

Raymond Vanholder, MD, PhD



Manish Sood, MD

Rita Suri, MD, Msc

Jean Ethier, MD*

David C. Mendelssohn, MD*



Li Zuo, MD – Beijing

Mei Wang, MD – Beijing

Fanfan Hou, MD, PhD – Guangzhou

Jiaqi Qian, MD – Shanghai

Nan Chen, MD – Shanghai

Yucheng Yan, MD, PhD – Shanghai



Christian Combe, MD

Luc Frimat, MD, PhD*

Fitsum Guebre-Egziabher, MD, PhD



Juergen Bommer, MD*

Werner Kleophas, MD

Elke Schaeffner, MD



Vittorio Andreucci, MD *

Francesco Locatelli, MD

Loreto Gesualdo, MD



Tadao Akizawa, MD, PhD

Masafumi Fukagawa, MD, PhD

Masaaki Inaba , MD, PhD

Masaomi Nangaku , MD, PhD

Kosaku Nitta, MD, PhD



Dr. Bassam Al Helal

Dr. Naser Alkandari

Dr. Ali Alsahow

Dr. Anas Alyousef


New Zealand

Mark R. Marshall, MD



Dr. Yacoub Al Maimani

Dr. Issa Alsalmi



Dr. Fadwa Al Ali

Dr. Abdulla Hamad



Dr. Anton Andrusev

Dr. Boris Bikbov

Dr. Natalia Tomilina

Dr. Alexander Zemchenkov                            


Saudi Arabia

Dr. Saeed Al-Ghamdi

Dr. Mohammed Al Ghonaim

Dr. Jamal Al Wakeel

Dr. Fayez Hejaili

Dr. Ayman Karkar

Dr. Faissal Shaheen



José Miguel Cruz, MD*

Luis Piera, MD *

Joan Fort, MD, PhD

Patricia de Sequera, MD



Stefan Jacobson, MD

Anders Christensson, MD, PhD



Dr. Kenan Ateş

Dr. Tevfik Ecder

Dr. Gültekin Süleymanlar


United Arab Emirates

Dr. Ali Abdulkarim Al Obaidli

Dr. Mona Al Rukhaimi

Dr. Samra Abouchacra

Dr. Mohamed Hassan

Dr. Abdul Kareem Saleh


United Kingdom

Roger Greenwood, MSc, MD, FRCP *

Hugh C. Rayner, MD, FRCP

Richard Fluck, MD

* Emeritus Country Investigator

The DOPPS team is also grateful for the service of the late Country Investigators: Erwin Hecking, MD, Germany; Fernando Valderrábano, MD, Spain; and Cengiz Utaş, MD, Turkey.

The DOPPS Steering Committee provides oversight for the study and guidance on the DOPPS research and publications. Members of the DSC represent major renal foundations, societies, and patient groups, as well as Arbor Research scientific leadership.

Bruce Robinson, MD, MSCE
Vice President, Research
DOPPS Principal Investigator


Anna Marti i Monros
European Dialysis and Transplant Nurses Association (EDTNA)


Ziad Massy, MD, PhD
European Dialysis and Transplant Association (EDTA)

Friedrich K. Port, MD, MS
Senior Investigator


Alfred Cheung, MD
American Society of Nephrology (ASN)


Bill Peckham, BS
Patient advocate

Ron Pisoni, PhD, MS
Senior Investigator


Kerry Willis, PhD
National Kidney Foundation (NKF)


Nathan Levin, MD
International Society of Nephrology (ISN)





Tadao Akizawa, MD, PhD
Japanese Society for Dialysis Therapy (JSDT)

The project team members of the DOPPS Coordinating Center manage the daily operations of the DOPPS. Overseeing the data collection worldwide, project team members recruit new facilities and work to ensure successful data collection at participating facilities. The DOPPS CC team members also develop the study protocol, questionnaires, and instruments. Research requests and general study inquiries can be directed to the Arbor Research DOPPS CC at

Any data collection questions or requests can be submitted by email to the DOPPS staff at the following locations:

Denise Gaudet
DMG Initiatives, Inc., Project Coordinator

Anna Marti Monros
EDTNA, Project Coordinator

J-DOPPS Coordinating Center
Kyowa Hakko Kirin Co., Ltd./ EP-PharmaLine Co., Ltd.

United States
DOPPS Coordinating Center

Study Recruitment

table showing the number of clinics and patients enrolled in the DOPPS by country.

Recruitment as of August 22, 2017

^  French data collection is currently on hold pending data protection approval

* GCC-6 countries are currently working through the recruitment and ethical approval processes

# China is scheduled to launch in Q1 of 2018


Recent Publications

Port FK, Robinson BM, McCullough KP, Morgenstern H. Predialysis blood pressure on survival in hemodialysis patients. Kidney Int 2017;91(3):755-756.

Port FK, Morgenstern H, Bieber BA, Karaboyas A, McCullough K, Tentori F, Pisoni RL, Robinson BM. Understanding associations of hemodialysis practices with clinical and patient-reported outcomes: Examples from the DOPPS. Nephrol Dial Transplant. 2017 Feb 11. [Epub ahead of print]

Karaboyas A, Zee J, Brunelli SM, Usvyat LA, Weiner DE, Maddux FW, Nissenson AR, Jadoul M, Locatelli F, Winkelmayer WC, Port FK, Robinson BM, Tentori F. Dialysate potassium, serum potassium, mortality, and arrhythmia events in hemodialysis: Results from the DOPPS. Am J Kidney Dis 2017;69(2):266-277.

The DOPPS has published over 200 peer-reviewed papers. To search publications on dialysis outcomes and practice patterns, please click here.