Haemodialysis (HD) is one form of kidney replacement treatment (KRT) for patients with kidney disease. HD removes fluid and toxins through diffusion and ultrafiltration. Isolated ultrafiltration (Iso Uf) may be performed to facilitate increased fluid removal, improve a patient’s tolerability, and achieve the ultrafiltration goal (UFG). Iso Uf can be performed in association with, or in addition to, standard HD and requires no additional equipment. However, although this type of treatment has been evident for decades, there is minimal current evidence in relation to clinical practice, assessment criteria and process evaluation. Current practice trends are often based on clinical judgement, experience and patient assessment. Inconsistent practices have therefore been raised as an area for investigation in order to define appropriate standards of clinical care. The aim of this paper is to understand current practices in relation to Iso Uf, including assessment criteria, treatment interventions and evaluation strategies, and compare this with currently available literature in order to scope treatment considerations.

Current healthcare systems often fail to recognise and address the healthcare needs of First Nations People, resulting in unacceptable gaps in health outcomes. Biomedical frameworks used to examine chronic conditions, like chronic kidney disease (CKD), focus on ill health rather than on the strengths First Nations People use to be resilient and sovereign. Healthcare systems, staff and researchers need to collaborate with First Nations People to understand and value lived experiences to best address health and wellbeing needs.

This research was carried out within Aboriginal Kidney care together: improving outcomes now (AKction). Using decolonised methods and a participatory action approach, research yarning and thematic analysis were collaboratively conducted to map the health journey of an Aboriginal woman with lived experience of kidney disease.

The woman utilised a range of strengthening factors to maintain resilience during her kidney health journey, including Ngolun/connections (to land, language, culture, spirit and ancestors; family; people who understood experiences; strong women; supportive health staff; community), Kunulun/actions (engaging with culture, taking control, advocacy and support, sharing knowledge) and Peranbun/positive mindset (identity, choosing to be strong, outlook on situation, focus). Lacking these strengths and life stressors contrastingly acted as a barrier to her resilience.

The woman’s journey acts as a case study providing recommendations for improving First Nations People’s kidney care by applying a person-centred approach. Recommendations include the need for relevant community kidney health education and awareness, early testing, treatment options on country, peer support, First Nations People healthcare staff, post-transplantation support, and holistic healthcare addressing the patients’ social and emotional wellbeing.