Preparing for kidney replacement therapy in pediatric advanced CKD: a review of literature and defining a multi-disciplinary clinical approach to patient-caregiver education.

TREATMENT of chronic kidney failure; THERAPEUTICS; CHRONIC kidney failure; IMPLICIT bias; CAREGIVERS; HUMAN comfort; RENAL replacement therapy; SOCIOECONOMIC factors; QUALITY of life; DECISION making; PATIENT education; COMORBIDITY

Pediatric patients with progressive chronic kidney disease (CKD) approaching kidney replacement therapy (KRT) make up a small population but carry significant morbidity and mortality. Patients and caregivers require comprehensive kidney failure education to ensure a smooth start to KRT. Choice of KRT modality can be influenced by medical comorbidities, patient/caregiver comprehension, and comfort with a particular modality, social and economic factors, and/or implicit bias of the health care team. As KRT modality can influence morbidity, mortality, and quality of life, we created a pediatric advanced CKD clinic to provide comprehensive KRT education and to promote informed decision-making for our advanced CKD patients and their caregivers. [ABSTRACT FROM AUTHOR]