Passed by the NKF September 1997 (Amended 2008 & 2019)

The National Kidney Federation believes that patient preference is important to the choice of dialysis therapy.

In making the appropriate choice of therapy, patient preference must be considered after informed guidance on options, taking into account medical and surgical contraindications. Transplantation should be considered as an alternative to dialysis.

There should be flexibility for change of therapy if the chosen treatment proves to be inappropriate for medical reasons or from personal choice.

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Note

The Dialysis Summit held in the House of Commons and hosted by the All Party Parliamentary Kidney Group on 12th July 2007 identified the following key challenge:-

Capacity

Dialysis provision (both home and in hospital) needs to be increased so that patients are no longer denied the choices offered throughout the rest of the National Health Service.

It then identified ten actions including:-

• “Enable choice of dialysis for every patient”
• “Ensure every patient has an individualised care plan”
• “Use the Renal Registry to plan and audit dialysis services”

It is our view that patient choice is limited by lack of adequate information to make an informed choice, by medical preference and, significantly, by cost constraints. Savings apparently achieved by inappropriate treatment may in the long run be more expensive because of recurrent illness and increased admission rates.

Treatment options that should be available to offer

• Hospital Haemodialysis (HD)
• Satellite Haemodialysis (HD)
• Home Haemodialysis (HHD)
• Continuous Ambulatory Peritoneal Dialysis (CAPD)
• Automated Peritoneal Dialysis (APD)
• Assisted Automated Peritoneal Dialysis (AAPD)
• Haemodiafilteration (HDF)
• Pre Dialysis Transplantation (PDT)