Patient preferences for kidney failure treatments.

Abstract

This review considers what is important to people when making decisions about their kidney failure care. We begin by introducing the concept of preferences, and how preference-sensitive decision-making is central to person-centered care. Next, we explore the preferences that patients have in relation to kidney failure care and the attributes of available treatments. We examine how decisions are made about kidney failure treatments and consider whether preference-sensitive care is widespread. Finally, we make recommendations regarding how kidney services could be reshaped to ensure that people's preferences guide the health care they receive. We conclude that people's preferences can guide decisions between treatments for kidney failure only if clinicians and systems facilitate this. The best treatment for a person is the one that fits best with what is important to them. The science of nephrology involves optimal delivery of treatments that prolong life and preserve and replace organ function. The art lies in shaping this care to the person.