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Shared Decision-Making for the Integrated Care of End-Stage Kidney Disease Patients

  • 1 Hajeong Lee, MD, PhD, is a professor in the Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
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End-stage kidney disease (ESKD), which requires kidney replacement therapy (KRT) or comprehensive conservative management, burdens patients, their families and caregivers, and the healthcare system. The selection of the type of KRT for individual patients is therefore decided based on not only each patient’s medical condition but also his or her family support, social and financial resources, and the healthcare resources he or she receives.

Most decisions regarding KRT have been based on physician- or healthcare system/stakeholder-centered determinations rather than “patient-centered” choices, and thus many patients with ESKD feel insufficiently involved in their treatment options. However, it is also important to

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