In its new guidance on renal replacement therapy, the National Institute for Health and Care Excellence (NICE) has recommended that individuals with kidney failure being treated with dialysis should be offered a choice over where and what type of treatment they receive. As per the new recommendations, patients should discuss with their clinicians and choose the type of dialysis and the setting for their treatment that is appropriate for them.
Peritoneal dialysis (PD) can be performed at home, while haemodialysis and haemodiafiltration (HDF) can be performed at home or in hospital. Earlier PD was the preferred option for individuals with residual renal function and adults without another significant disease or disorder. Children <2 years will continue to receive PD as the primary option. NICE recommends offering HDF as the primary option to individuals opting for treatment in hospital.
The type and the setting of dialysis are crucial as they can affect an individual's life in many ways, e.g. ability to travel. NICE has also recommended providing information, education and support patients, families and carers, to assist them in making informed decisions about renal replacement. Additionally, NICE has recommended ensuring that the decision to initiate dialysis should be collectively made by the patient and their healthcare team.
