Discusses the need for reliable research‐based evidence detailing the costs and benefits provided by different operational and strategic structures of renal replacement therapy. Suggests that in choosing the most appropriate form of dialysis the treatment options may be limited for clinical, practical or financial reasons. Proposes that the renal services must support patients in empowering them to make informed choices concerning the dialysis modality which offers them the highest quality of life. Brings into perspective the need for a balance between patients’ quality of life and the financial constraints on the NHS.
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