Most haemodialysis (HD) patients are conventionally prescribed a thrice weekly schedule at initiation. An incremental approach to dialysis initiation (i.e. starting at 1-2/week and increasing as needed) may offer potential benefits including preservation of residual renal function, preservation of fistula and reduced costs. In preparation for a prospective study, we examined a cohort of patients who commenced HD in 2017 at our institution and extrapolated demographic and biochemical data. All incident patients who commenced HD in 2017 were included. A total of 39 patients were analysed. 13/39 (33%) were female. Age range was between 31 and 84 with a median age of 58 years. The cause of end stage kidney disease was diabetic nephropathy in the majority of patients (46%). The second commonest cause was autosomal dominant polycystic kidney disease (15%). Other causes were hypertensive nephropathy, glomerulonephritis, renal cell carcinoma, multiple myeloma, cardiorenal syndrome and congenital disease. 54% of the group had diabetes as a co-morbidity that did not always lead to diabetic nephropathy. 7/39 (18%) patients commencing HD in 2017 had a twice weekly initiation. Out of these 7 patients, 3 were a planned start via a well-developed fistula. 2 patients commenced dialysis via a tunnelled catheter and the remaining two were commenced using temporary internal jugular catheters. The following table compares characteristics between the cohort of patients started on twice weekly vs thrice weekly HD. 18% of incident HD patients stated dialysis at twice weekly frequency. Patients who start at incremental frequency were on average older, had larger body weight at initiation and lower interdialytic weight gain (IDWG) at one month compared to those who started at three times weekly frequency. Incremental start haemodialysis appears to be a feasible approach in a sizeable portion of incident haemodialysis patients.