Options for Dialysis and Vascular Access Creation

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Patient-Centered Care

Background:

• End-stage kidney disease (ESKD) impacts a significant patient population in the United States.
• Dialysis modality selection (peritoneal dialysis vs. hemodialysis) necessitates a personalized strategy.
• The development of a comprehensive ESKD Life-Plan is essential for optimal patient outcomes.

Purpose of the Study:

• To emphasize the importance of patient-centric decision-making in choosing between peritoneal dialysis (PD) and hemodialysis (HD).
• To highlight the critical role of an ESKD Life-Plan in guiding access selection.
• To advocate for the investigation of advanced and complex access techniques.

Main Methods:

• Review of current practices and literature regarding dialysis access.
• Emphasis on shared decision-making principles in clinical practice.
• Consideration of evolving percutaneous access techniques for both PD and HD.

Main Results:

• The selection of dialysis modality and access should be tailored to individual patient needs and circumstances.
• Complex access options should be explored when standard approaches are insufficient.
• Further research into novel percutaneous access methods is warranted.

Conclusions:

• A patient-centric ESKD Life-Plan is crucial for optimizing dialysis access.
• Shared decision-making and palliative care integration are vital components of CKD and ESKD management.
• Exploration of evolving techniques like percutaneous access can enhance treatment options.