Preparing the patient for renal replacement therapy. Teamwork optimizes outcomes

Proper preparation of a patient with CKD for the development of ESRD and the need for RRT is essential to optimize the patient's quality and quantity of life and to help ensure positive economic and societal outcomes. A collaborative team approach involving the primary care physician team, the patient and his or her family and friends, and the nephrology team should result in improved care of the CKD patient and improved outcomes. It is not possible, feasible, or practical to attempt to provide the inclusive care necessary to attain these goals in a system that does not take advantage of the strengths of a team approach. Adopting this concept of care for patients with kidney disease results in a win-win situation for all of the participants--the patients, the physicians, and society.