KDOQI US Commentary on the 2020 ISPD Practice Recommendations for Prescribing High-Quality Goal-Directed Peritoneal...

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Therapy

Background:

• The 2020 International Society for Peritoneal Dialysis (ISPD) guidelines introduce a paradigm shift in peritoneal dialysis (PD) prescription.
• These recommendations move away from traditional "adequacy" metrics towards a high-quality, goal-directed, and person-centered approach.

Purpose of the Study:

• To assess the 2020 ISPD practice recommendations on goal-directed PD.
• To provide guidance for US clinical providers on interpreting and implementing these new recommendations.
• To facilitate a transition towards a more holistic and person-centered PD care model.

Main Methods:

• A work group convened by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) reviewed the ISPD recommendations.
• The commentary synthesizes expert views on the implications and implementation strategies for these guidelines within the US clinical context.

Main Results:

• The ISPD recommendations emphasize shared decision-making and a broader consideration of individual patient needs.
• Recommendations are presented as "practice points" due to limited robust evidence, requiring careful clinical interpretation.
• Implementation necessitates a change in the current clinical paradigm, including increased resource allocation for enhanced, person-centered services.

Conclusions:

• The new ISPD guidelines advocate for a fundamental change in PD prescription, prioritizing individual patient goals and shared decision-making.
• Successful implementation requires a shift in clinical practice and resource allocation to support a more comprehensive, person-centered approach to PD quality.
• This commentary serves as a crucial resource for US clinicians navigating the adoption of these evolving PD practice recommendations.