Table 1.

Role of Multidisciplinary Team Members.

Team member	Role pre-creation	Role post-creation
Nephrologist	Educate patients, often with the CKD educator regarding CKD progression and RRT modality options Educate patient re: choice of dialysis access based on clinical circumstances (comorbidities, rate of progression) Discuss risks and benefits of peritoneal catheter and hemodialysis vascular access. Provide timely referral to the surgeon and/or interventionist.	Monitor, along with the Vascular Access coordinator, the access after creation for signs of complications and facilitate interventions to maintain long-term function. Manage vascular access complications (eg, catheter-related malfunction or infection or fistula or graft complications?).
Surgeon/interventional radiologist or nephrologist	Evaluate re: choice of vascular access based on patient and vessel characteristics (optimally, in conjunction with information provided by the nephrologist regarding the patient’s anticipated time to initiation of dialysis). Discuss surgical and interventional risks and benefits for each access with patient/family.	Create the vascular access and manage immediate perioperative complications including revisions as required. Perform facilitative and/or corrective procedures to attain and/or maintain patency, eg, coil embolization, angioplasty, thrombolysis.
Peritoneal and/or vascular access coordinator	Facilitate communication between nephrologist, surgeon, radiologist and patient/family. Coordinate peritoneal dialysis or hemodialysis vascular access management (eg, booking of diagnostic tests, communicates with patient re: dialysis access appointments, etc).	Monitor patient’s dialysis access on a regular basis and informs nephrologist and/or surgeon/interventionist of concerns. Key “point person” for patient when access issues arise.
Patient and family	Provide information about patient’s life circumstances (social, occupational, cultural, spiritual, functional, etc). Provide information about patient dialysis access preferences, life goals, and concerns. Ask questions to ensure they understand various dialysis access options to their satisfaction.	Provide information regarding any changes in life circumstances or preferences

Note. RRT = renal replacement therapy.