Chapter 2: Algorithm for Renal Replacement Therapy (RRT) options

This chapter addresses multiple levels of renal replacement therapies (RRTs)¹²³⁴. It is about selecting the most appropriate mode of therapy site and type of dialysis access. The algorithms outlined in this module are designed to be simplistic and practical derived from a multilayered complex reality of systems in drift.   A lifelong strategy also includes prevention of progression of ESRD, considering several types of renal transplantation, mode of dialysis before it is needed, and type and site of dialysis access at the appropriate time. This needs much foresight into planning and preparation and teaching to prevent poor outcome⁷. Sadly, the status of affairs is far from reality. To achieve outcomes that are realistic requires true synergistic teamwork where cooperation and trust are key ingredients for success²³.

Much controversy surrounds the selection of the appropriate renal replacement therapy (RRT), including mode of dialysis, type and site of dialysis access, when to place and when to start dialysis and who places the access. This conundrum is reflected by the wide geographical variation in how renal replacement therapy strategies are applied⁶.

Chapter content coming soon.