Abstract
There are several modalities for treatment replacing kidney function and a patient can be treated with all of them at various points during his lifetime. The patient should be informed about all available treatment modalities in a timely manner.
This information should be available to the patient's relatives as well. A patient without contraindications for kidney transplantation should either undergo transplantation from a living donor or be entered into a transplantation waiting list prior to commencing dialysis treatment (pre-emptive transplantation).
A patient indicated for kidney transplantation should be treated with peritoneal dialysis as the 1st choice method. A patient who cannot receive a kidney transplant should be informed about what the other options are - haemodialysis, at-home haemodialysis, peritoneal dialysis and conservative treatment.
A patient who opts for haemodialysis should have vascular access prepared in time. An AV fistulla is preferred or an AV graft.
Vascular access should be prepared roughly four months before commencing dialysis treatment, when glomerular filtration gets below 0.2 ml/s. Older patients can benefit from conservative treatment of chronic kidney failure.