The number of patients requiring kidney replacement therapy (KRT) has increased dramatically throughout the world over the last four decades, however there is significant variability in the practice of KRT initiation. Recent evidence has suggested that sub-optimal start to dialysis is associated with poor survival, but the optimal approach for the individual is not clearly defined. As such, decisions concerning the optimal approach will guide timing and preparation for modality selection, appropriate dialysis access and initiation, and ultimately the prescribed and delivered dose of dialysis. The aim is to achieve patient objectives in symptom control, dialysis outcomes and lifestyle.

The KDIGO Controversies Conference on Dialysis Initiation, Modality Choice and Prescription was the first in a series of dialysis meetings which identified gaps in knowledge and consensus among various stakeholders to provide a blueprint for delivery of optimal contemporary KRT.

The conference was led by Dr. Carol Pollock, nephrologist and Professor of Medicine, University of Sydney, Northern Clinical School, Kolling Institute of Medical Research, Australia and Dr. Christopher Chan, nephrologist and Professor of Medicine from the University of Toronto, University Health Network, Canada.

Below is a recorded webinar on Dialysis Initiation, Modality Choice & Prescription featuring Christopher Chan, one of the co-chairs of the KDIGO Dialysis Initiation, Modality Choice & Prescription Controversies Conference, and Anthony Bleyer, one of the expert meeting participants. The webinar was developed in collaboration with the International Society of Nephrology, and held on September 18, 2018.