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 fourteen 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.

Current Country Investigators


Dr. Ali Al-Aradi


Michel Jadoul, MD

Pieter Evenepoel, MD, PhD


Manish Sood, MD

Rita Suri, MD, Msc


Li Zuo, MD, PhD – Beijing

Yuqing  Chen, MD – Beijing

Zhaohui Ni, MD, PhD – Shanghai

Xiaonong Chen, MD – Shanghai

Fanfan Hou, MD, PhD – Guangzhou

Xinling Liang, MD – Guangzhou


Christian Combe, MD

Fitsum Guebre-Egziabher, MD, PhD

Pablo Antonio Ureña Torres, MD


Werner Kleophas, MD

Elke Schaeffner, MD

Thomas Weinreich, MD



Giuliano Brunori, MD

Piergiorio Messa, MD


Kosaku Nitta, MD, PhD

Masaaki Inaba , MD, PhD

Masafumi Fukagawa, MD, PhD

Ken Sakai, MD, PhD

Kazuhiko Tsuruya, MD, PhD

Takayuki Hamano, MD, PhD

Hirokazu Honda, MD, PhD

Junichi Hoshino, MD, PhD

Hirotaka Komaba, MD, PhD

Toshiaki Nakano, MD, PhD


Dr. Bassam Al Helal

Dr. Naser Alkandari

Dr. Heba AlRajab

Dr. Anas Alyousef


Dr. Yacoub Al Maimani

Dr. Issa Alsalmi


Dr. Fadwa Al Ali

Dr. Abdulla Hamad


Saudi Arabia

Dr. Saeed Al-Ghamdi

Dr. Mohammed Al Ghonaim

Dr. Jamal Al Wakeel

Dr. Fayez Hejaili

Dr. Ayman Karkar

Dr. Faissal Shaheen


Aleix Cases, MD, PhD

Almudena Vega Martínez, MD, PhD


Stefan Jacobson, MD

Anders Christensson, MD, PhD

United Arab Emirates

Dr. Ali Abdulkarim Al Obaidli

Dr. Mona Al Rukhaimi

Dr. Mohamed Hassan

Dr. Abdul Kareem Saleh

United Kingdom

Elham Asgari, MRCP (UK), MSc, PhD

Indranil Dasgupta, MBBS, MD, DM, FRCP (Lond)

Emeritus Country Investigators

Dr. Samra Abouchacra

Dr. Takashi Akiba

Prof. Tadao Akizawa

Dr. Sumaya Al Ghareeb

Dr. Ali Alsahow

Vittorio Andreucci, MD

Dr. Anton Andrusev

Dr. Yasushi Asano

Dr. Kenan Ateş

Dr. Boris Bikbov

Juergen Bommer, MD

Bernard Canaud, MD, PhD

Nan Chen, MD

Dr. John Collins

José Miguel Cruz, MD

Patricia de Sequera, MD, PhD

Alex Disney, MD

Dr. Tevfik Ecder


Jean Ethier, MD

Richard Fluck, MD

Joan Fort, MD, PhD

Luc Frimat, MD, PhD

Dr. Shunichi Fukuhara

Martin Gallagher, MD

Loreto Gesualdo, MD, FERA

Dr. Karl Goran-Prutz

Roger Greenwood, MSc, MD, FRCP

Peter Kerr, MD

Dr. Kiyoshi Kurokawa

Norbert H. Lameire, MD

Francesco Locatelli, MD

Mark R. Marshall, MD

Dr. Fumiaki Marumo

David C. Mendelssohn, MD


Luis Piera, MD

Jiaqi Qian, MD

Hugh C. Rayner, MD, FRCP

Dr. Akira Saito

Dr. Gültekin Süleymanlar

Dr. Natalia Tomilina

Dr. Fernando Valderrábano

Raymond Vanholder, MD, PhD

Mei Wang, MD

Björn Wikström, MD

Dr. Volker Wizemann

Yucheng Yan, MD, PhD

Dr. Alexander Zemchenkov

The DOPPS team is also grateful for the service of the late Country Investigators: Erwin Hecking, MD; Fernando Valderrábano, MD; Cengiz Utaş, MD; and Dr. Sumaya Al Ghareeb.

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 Arbor Research 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
Regional Study Coordination
In some areas, we rely on regional coordinating partners to facilitate study operations. Any data collection questions or requests can be submitted by email to the DOPPS staff at the following locations:

Anna Marti Monros
EDTNA, Project Manager

J-DOPPS Coordinating Center
The Kidney Foundation, Japan

United States
DOPPS Coordinating Center



Recent Publications

Wang J, Bieber BA, Hou FF, Port FK, Anand S. Mineral and bone disorder and management in the China Dialysis Outcomes and Practice Patterns Study. Chin Med J (Engl). 2019;132 (23), 2775-2782
AlSahow A, Muenz D,  Al-Ghonaim MA, Al Salmi I, Hassan M, Al Aradi AH, Hamad A,  Al-Ghamdi SMG, Shaheen FAM, Alyousef A, Bieber BA,  Robinson BM, Pisoni RL. Kt/V: achievement, predictors and relationship to mortality in hemodialysis patients in the Gulf Cooperation Council countries: results from DOPPS (2012–18). Clinical Kidney Journal, sfz195,
Karaboyas A, Morgenstern H, Li Y, Bieber BA, Hakim R, Hasegawa T, Jadoul M, Schaeffner E, Vanholder R, Pisoni RL, Port FK, Robinson BM. Estimating the Fraction of First-Year Hemodialysis Deaths Attributable to Potentially Modifiable Risk Factors: Results from the DOPPS. Clin Epidemiol 2020:12 51–60.
Perl J, Fuller DS, Bieber BA, Boudville N, Kanjanabuch T, Ito Y, Nessim SJ, Piraino BM, Pisoni RL, Robinson BM, Schaubel DE, Schreiber MJ, Teitelbaum I, Woodrow G, Zhao J, Johnson DW. Peritoneal Dialysis-Related Infection Rates and Outcomes: Results From the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). Am J Kidney Dis. 2020 Jan 10.  doi: 10.1053/j.ajkd.2019.09.016. [Epub ahead of print]
Wang AY, Zhao J, Bieber B, Kanjanabuch T, Wilkie M, Marshall MR, Kawanishi H, Perl J, Davies S; PDOPPS Dialysis Prescription and Fluid Management Working Group. International comparison of peritoneal dialysis prescriptions from the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). Perit Dial Int. 2020 Jan 17: doi: 10.1177/0896860819895356. [Epub ahead of print]

The DOPPS has published over 300 peer-reviewed papers. To search publications on dialysis outcomes and practice patterns, please click here.