Objective
There is evidence to suggest that home patients on extended hours do better and are able to cease phosphate binders and achieve serum phosphate levels within the normal limit. These patients have opted to do longer hours and are generally a fitter younger patient. However these findings have never been put into a comparative randomised study The ACTIVE trial is a pilot, to study the effects of extended dialysis (more than 24hrs per wk), compared to standard dialysis (less than 18hrs per wk). This evidence will have direct relevance to decisions about the care of patients with ESKD.

Method
Sample size of pilot trial will be 40 patients with approximately 6 from the Sydney Adventist Hospital. It will be an open label, randomised controlled trial of extended hrs vs. standard hrs. Patient will participate for a 12 month duration. Data collected will include physical examination, medical history, vital signs, blood results and quality of life questionnaires KDQOL-SF 1.3 and EQ-5D.

Conclusion
Offering extended hours has proved feasible through modifications to the dialysis rostering system, the dialysis prescription and to routine biochemical monitoring. The first participants were randomised and have completed 6 months of the trial.
Conducting extended hours in an in-centre unit poses special challenges for patients, nursing staff and administration but is achievable and will provide invaluable evidence on ways to improve the well-being of haemodialysis patients.