Decision process about options in renal therapy substitution: selection versus election

No renal replacement therapy stands alone. Hemodialysis, peritoneal dialysis and transplantation each have a role to play in the care of our patients. When one fails, another can replace that modality. Patients and staff should be counselled accordingly. The responsibility of healthcare workers is to try to best match the medical condition and lifestyle of the patients with the renal replacement therapy available. Furthermore the patients should have sufficient information to be able to make these decisions wisely.