Visual summary
A planned treatment should be reassessed when health, function, or goals change. Shared decisions continue after kidney replacement begins.
Text version
Options extend beyond one machine
Hemodialysis, peritoneal dialysis, transplantation, and comprehensive conservative care differ in burden, support needs, and goals.
Start with priorities
Discuss longevity, symptom relief, independence, travel, caregiver workload, and the patient's understanding of prognosis. Preferences may change over time.
Assess readiness
Kidney trajectory, complications, access options, home circumstances, and transplant eligibility guide preparation. A filtration estimate alone is not a complete starting rule.
Prepare deliberately
Provide modality education, access or catheter planning, vaccination review, and a clear follow-up pathway before urgent treatment becomes necessary.
Watch symptoms and complications
Refractory fluid overload, electrolyte or acid–base problems, uremic symptoms, and nutritional deterioration can change the timing decision.
Revisit the choice
A planned treatment should be reassessed when health, function, or goals change. Shared decisions continue after kidney replacement begins.
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