| Theme |
Medical treatment, nursing care, and life support for patients with advanced CKD stages |
| Title |
Shared decision making on renal replacement therapy ; doctor's aspect |
| Author |
Hidetoshi Kanai |
Department of Nephrology, Kokura Memorial Hospital |
| [ Summary ] |
There is no difference between the efficacy of HD or PD in the first two years after initiation of renal replacement therapy for uremic function. The proper modality for renal replacement therapy must be decided in terms of both medical and social factors. HD may be chosen to preserve residual kidney function. To achieve precise ECF control in anuric patients PD is an appropriate treatment choice. HD is suitable for patients with documented loss of peritoneal function, when PD is not a suitable treatment option due to mechanical defects or when there is infection. PD is suitable for patients who prefer PD, choose not to have HD, or cannot tolerate HD, as well as those lacking assistance for care in HD treatment centers or at home. |